Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee.
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ICR Authors
Authors
van Ewijk, R
Chatziantoniou, C
Adams, M
Bertolini, P
Bisogno, G
Bouhamama, A
Caro-Dominguez, P
Charon, V
Coma, A
Dandis, R
Devalck, C
De Donno, G
Ferrari, A
Fiocco, M
Gallego, S
Giraudo, C
Glosli, H
Ter Horst, SAJ
Jenney, M
Klein, WM
Leemans, A
Leseur, J
Mandeville, HC
McHugh, K
Merks, JHM
Minard-Colin, V
Moalla, S
Morosi, C
Orbach, D
Ording Muller, L-S
Pace, E
Di Paolo, PL
Perruccio, K
Quaglietta, L
Renard, M
van Rijn, RR
Ruggiero, A
Sirvent, SI
De Luca, A
Schoot, RA
Chatziantoniou, C
Adams, M
Bertolini, P
Bisogno, G
Bouhamama, A
Caro-Dominguez, P
Charon, V
Coma, A
Dandis, R
Devalck, C
De Donno, G
Ferrari, A
Fiocco, M
Gallego, S
Giraudo, C
Glosli, H
Ter Horst, SAJ
Jenney, M
Klein, WM
Leemans, A
Leseur, J
Mandeville, HC
McHugh, K
Merks, JHM
Minard-Colin, V
Moalla, S
Morosi, C
Orbach, D
Ording Muller, L-S
Pace, E
Di Paolo, PL
Perruccio, K
Quaglietta, L
Renard, M
van Rijn, RR
Ruggiero, A
Sirvent, SI
De Luca, A
Schoot, RA
Document Type
Journal Article
Date
2023-11-01
Date Accepted
2023-08-07
Abstract
OBJECTIVE: To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma. MATERIAL AND METHODS: We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted. RESULTS: Of 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1-1.2) (all ADC expressed in * 10-3 mm2/s), versus 1.6 (1.5-1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7-0.9) at diagnosis and 1.1 (1.0-1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3-0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6-3.2]) between the mean ADC change and event-free survival. CONCLUSION: A significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients.
Citation
Pediatric Radiology, 2023, 53 (12), pp. 2539 - 2551
Source Title
Pediatric Radiology
Publisher
SPRINGER
ISSN
0301-0449
eISSN
1432-1998
1432-1998
1432-1998
Collections
Research Team
Paed & Adolesc Radiother