Abstract
BackgroundThe purpose of the study is assessing the diagnostic merits of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in evaluating tumor response to chemo-radiotherapy. The study included 36 patients with soft tissue sarcoma, who received chemo/radiotherapy. Tumor longest dimension according to response evaluation criteria in solid tumors 1.1 (RECIST 1.1), the longest dimension of the contrast-enhanced portion of the tumor according to modified response evaluation criteria in solid tumors: (mRECIST), the tumor volume (VOL) (cm3), and DWI with ADC values were recorded.ResultsADC values in the non-progressive group were higher than those of the progressive group after neoadjuvant treatment (1.63 ± 0.42 vs. 1.24 ± 0.35) with (p < 0.005). ADC variations in the non-progressive group were higher than those of the progressive group (27.09 ± 48.09 vs. − 3.08 ± 23.5)% with (p < 0.05). ADC values after neoadjuvant treatment were negatively related to tumor volume variations (VOL%) after neoadjuvant treatment. ADC variations (ADC%) were inversely correlated with morphologic changes, regardless of the effectiveness of anticancer therapy expressed as changes in tumor size based on (RECIST, mRECIST, and three-dimensional volumetric assessment). An increase in the ADC value was not always associated with a reduction of tumor volume.ConclusionQuantitative DW imaging after neoadjuvant therapy provides added value in determining treatment response in soft tissue sarcomas. Therapeutic response to neoadjuvant therapy can be underestimated using RECIST 1.1; therefore, the mRECIST should also be considered.
Highlights
The purpose of the study is assessing the diagnostic merits of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in evaluating tumor response to chemo-radiotherapy
Proven soft tissue sarcoma patients receiving neoadjuvant chemo and/or radiotherapy were referred to radiology department for assessment of response to the neoadjuvant therapy
Initial baseline Magnetic resonance imaging (MRI) was performed for all patients before the initiation of neoadjuvant therapy and all patients performed at least one post-treatment follow up MRI examination
Summary
The purpose of the study is assessing the diagnostic merits of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in evaluating tumor response to chemo-radiotherapy. The study included 36 patients with soft tissue sarcoma, who received chemo/radiotherapy. Soft tissue sarcomas (STSs) are a gathering of uncommon malignancies that make up just 1–2% of all tumors in grown-ups while representing a higher extent of 15% of all malignancies in children. Careful resection (with suitably negative margins) is the standard essential treatment for most patients with STS, albeit close edges might be important to protect uninvolved critical neurovascular structures [3]. Radiotherapy and/or chemotherapy (on account of chemosensitive histologies) are often used before surgery in many centers to downstage enormous, high-grade tumors to empower compelling careful resection [3].
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