Evaluation of the Prognostic Value of Pretherapeutic Magnetic Resonance Imaging in Predicting Soft Tissue Sarcoma Radiation Response: A Retrospective Study from a Large Institutional Sarcoma Imaging Database

Author:

Vogin Guillaume123ORCID,Lepage Matthias4ORCID,Salleron Julia5ORCID,Cuenin Mathilde1,Blum Alain4,Gondim Teixeira Pedro Augusto46

Affiliation:

1. Department of Radiation Therapy, Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France

2. Centre François Baclesse, Centre National de Radiothérapie du Luxembourg, BP436, L-4005 Esch-sur-Alzette, Luxembourg

3. UMR 7365 CNRS-UL IMoPA, Biopôle de l’Université de Lorraine, Campus Brabois Santé, 9 Avenue de la Forêt de Haye, BP 20199, 54505 Vandœuvre-lès-Nancy, France

4. Guilloz Imaging Department, University Hospital Center of Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy, France

5. Biostatistics Unit, Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France

6. Université de Lorraine, IADI, Inserm U1254, Bâtiment Recherche CHRU de Nancy Brabois, 5 Rue du Morvan, 54500 Vandœuvre-lès-Nancy, France

Abstract

Background: RT-induced hyalinization/fibrosis was recently evidenced as a significant independent predictor for complete response to neoadjuvant radiotherapy (RT) and survival in patients with soft tissue sarcoma (STS). Purpose: Non-invasive predictive markers of histologic response after neoadjuvant RT of STS are expected. Materials and Methods: From May 2010 to April 2017, patients with a diagnosis of STS who underwent neoadjuvant RT for limb STS were retrieved from a single center prospective clinical imaging database. Tumor Apparent Diffusion Coefficients (ADC) and areas under the time-intensity perfusion curve (AUC) were compared with the histologic necrosis ratio, fibrosis, and cellularity in post-surgical specimens. Results: We retrieved 29 patients. The median ADC value was 134.3 × 10−3 mm2/s. ADC values positively correlated with the post-treatment tumor necrosis ratio (p = 0.013). Median ADC values were lower in patients with less than 50% necrosis and higher in those with more than 50% (120.3 × 10−3 mm2/s and 202.0 × 10−3 mm2/s, respectively (p = 0.020). ADC values higher than 161 × 10−3 mm2/s presented a 95% sensitivity and a 55% specificity for the identification of tumors with more than 50% tumor necrosis ratio. Tumor-to-muscle AUC ratios were associated with histologic fibrosis (p = 0.036). Conclusions: ADC and perfusion AUC correlated, respectively, with radiation-induced tumor necrosis and fibrosis.

Publisher

MDPI AG

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