Michal Chodyla1, Aydin Demircioglu1, Benedikt M Schaarschmidt1, Stefanie Bertram2, Janna Morawitz3, Sebastian Bauer4, Lars Podleska5, Christoph Rischpler6, Michael Forsting1, Ken Herrmann6, Lale Umutlu1, Johannes Grueneisen1. 1. Department of Diagnostic and Interventional Radiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany. 2. Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany. 3. Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, 40225 Dusseldorf, Germany. 4. Sarcoma Center, Western German Cancer Center, University of Duisburg-Essen, 45147 Essen, Germany. 5. Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany. 6. Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.
Abstract
BACKGROUND: To evaluate the potential of simultaneously acquired 18F-FDG PET- and MR-derived quantitative imaging data sets of primary soft-tissue sarcomas for the prediction of neoadjuvant treatment response, the metastatic status and tumor grade. METHODS: A total of 52 patients with a high-risk soft-tissue sarcoma underwent a 18F-FDG PET/MR examination within one week before the start of neoadjuvant treatment. For each patient, the maximum tumor size, metabolic activity (SUVs), and diffusion-restriction (ADC values) of the tumor manifestations were determined. A Mann-Whitney-U test was used, and ROC analysis was performed to evaluate the potential to predict histopathological treatment response, the metastatic status or tumor grade. The results from the histopathological analysis served as reference standard. RESULTS: Soft-tissue sarcomas with a histopathological treatment response revealed a significantly higher metabolic activity than tumors in the non-responder group. In addition, grade 3 tumors showed a significant higher 18F-FDG uptake than grade 2 tumors. Furthermore, no significant correlation between the different outcome variables and tumor size or calculated ADC-values could be identified. CONCLUSION: Measurements of the metabolic activity of primary and untreated soft-tissue sarcomas could non-invasively deliver relevant information that may be used for treatment planning and risk-stratification of high-risk sarcoma patients in a pretherapeutic setting.
BACKGROUND: To evaluate the potential of simultaneously acquired 18F-FDG PET- and MR-derived quantitative imaging data sets of primary soft-tissue sarcomas for the prediction of neoadjuvant treatment response, the metastatic status and tumor grade. METHODS: A total of 52 patients with a high-risk soft-tissue sarcoma underwent a 18F-FDG PET/MR examination within one week before the start of neoadjuvant treatment. For each patient, the maximum tumor size, metabolic activity (SUVs), and diffusion-restriction (ADC values) of the tumor manifestations were determined. A Mann-Whitney-U test was used, and ROC analysis was performed to evaluate the potential to predict histopathological treatment response, the metastatic status or tumor grade. The results from the histopathological analysis served as reference standard. RESULTS: Soft-tissue sarcomas with a histopathological treatment response revealed a significantly higher metabolic activity than tumors in the non-responder group. In addition, grade 3 tumors showed a significant higher 18F-FDG uptake than grade 2 tumors. Furthermore, no significant correlation between the different outcome variables and tumor size or calculated ADC-values could be identified. CONCLUSION: Measurements of the metabolic activity of primary and untreated soft-tissue sarcomas could non-invasively deliver relevant information that may be used for treatment planning and risk-stratification of high-risk sarcomapatients in a pretherapeutic setting.
Authors: Gijsbert M Kalisvaart; Willem Grootjans; Judith V M G Bovée; Hans Gelderblom; Jos A van der Hage; Michiel A J van de Sande; Floris H P van Velden; Johan L Bloem; Lioe-Fee de Geus-Oei Journal: Diagnostics (Basel) Date: 2021-12-04