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Quantitative magnetic resonance imaging (q-MRI) for the assessment of soft-tissue sarcoma treatment response: a narrative case review of technique development

  • Brandon K.K. Fields
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Darryl Hwang
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Steven Cen
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Bhushan Desai
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Mittul Gulati
    Affiliations
    Kaiser Permanente Los Angeles Medical Center, Department of Radiology, Los Angeles, CA 90027, United States of America
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  • James Hu
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Oncology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Vinay Duddalwar
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • Bino Varghese
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
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  • George R. Matcuk Jr
    Correspondence
    Corresponding author at: Department of Radiology, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Suite L1600, Los Angeles, CA 90033, United States of America.
    Affiliations
    Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America

    Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America
    Search for articles by this author
Published:February 27, 2020DOI:https://doi.org/10.1016/j.clinimag.2020.02.016

      Highlights

      • Soft-tissue sarcomas may not shrink in response to chemotherapy despite adequate treatment.
      • Decreased attenuation or contrast enhancement more accurately predicts sarcoma treatment response.
      • Quantitative MRI of sarcomas can estimate necrosis and viable tumor volume to assess treatment response.

      Abstract

      Soft-tissue sarcomas are a heterogeneous class of tumors that exhibit varying degrees of cellularity and cystic degeneration in response to neoadjuvant chemotherapy. This creates unique challenges in the radiographic assessment of treatment response when relying on conventional markers such as tumor diameter (RECIST criteria). In this case series, we provide a narrative discussion of technique development for whole tumor volume quantitative magnetic resonance imaging (q-MRI), highlighting cases from a small pilot study of 8 patients (9 tumors) pre- and post-neoadjuvant chemotherapy. One of the methods of q-MRI analysis (the “constant-cutoff” technique) was able to predict responders versus non-responders based on percent necrosis and viable tumor volume calculations (p = 0.05), respectively. Our results suggest that q-MRI of whole tumor volume contrast enhancement may have a role in tumor response assessment, although further validation is needed.

      Keywords

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