TY - JOUR
T1 - Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma
T2 - an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee
AU - van Ewijk, Roelof
AU - Chatziantoniou, Cyrano
AU - Adams, Madeleine
AU - Bertolini, Patrizia
AU - Bisogno, Gianni
AU - Bouhamama, Amine
AU - Caro-Dominguez, Pablo
AU - Charon, Valerie
AU - Coma, Ana
AU - Dandis, Rana
AU - Devalck, Christine
AU - de Donno, Giulia
AU - Ferrari, Andrea
AU - Fiocco, Marta
AU - Gallego, Soledad
AU - Giraudo, Chiara
AU - Glosli, Heidi
AU - ter Horst, Simone A. J.
AU - Jenney, Meriel
AU - Klein, Willemijn M.
AU - Leemans, Alexander
AU - Leseur, Julie
AU - Mandeville, Henry C.
AU - McHugh, Kieran
AU - Merks, Johannes H. M.
AU - Minard-Colin, Veronique
AU - Moalla, Salma
AU - Morosi, Carlo
AU - Orbach, Daniel
AU - Ording Muller, Lil-Sofie
AU - Pace, Erika
AU - di Paolo, Pier Luigi
AU - Perruccio, Katia
AU - Quaglietta, Lucia
AU - Renard, Marleen
AU - van Rijn, Rick R.
AU - Ruggiero, Antonio
AU - Sirvent, Sara I.
AU - de Luca, Alberto
AU - Schoot, Reineke A.
N1 - Funding Information: The authors would like to thank all patients and parents for contributing. The authors would like to thank Sarah Kelly and Anne Blondeel within of the Quality and Excellence in Radiotherapy and Imaging for Children and Adolescents with Cancer across Europe in Clinical Trials (QUARTET) group of the European Society of Paediatric Oncology (SIOPE), Hafida Lmalem imaging manager of the European Organisation for Research and Treatment of Cancer (EORTC) and Nicola Fenwick of the Cancer Research UK Clinical Trials Unit (CRCTU) for their support in the design of the data collection platform and logistics. The authors would like to thank Ilaria Zanetti and Beatrice Coppadoro of the clinical trials unit of the Pediatric Hematology Oncology Division, University Hospital of Padua, and the Department of Women’s and Children’s Health, University of Padua, Padua, Italy, for their help with the extraction of the retrospective RMS2005 and MTS2008 data of the European paediatric Soft tissue sarcoma Study Group (Ep SSG). Funding Information: R.E. and C.C. are funded by the KIKA Foundation (Children Cancer-free, number 357). H.M. acknowledges NHS funding from the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research. Publisher Copyright: © 2023, The Author(s).
PY - 2023/11
Y1 - 2023/11
N2 - 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. Graphical Abstract: [Figure not available: see fulltext.]
AB - 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. Graphical Abstract: [Figure not available: see fulltext.]
KW - Biomarker
KW - Diffusion magnetic resonance imaging
KW - Rhabdomyosarcoma
KW - Sarcoma
KW - Surrogate marker
UR - http://www.scopus.com/inward/record.url?scp=85170374920&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00247-023-05745-z
DO - https://doi.org/10.1007/s00247-023-05745-z
M3 - Article
C2 - 37682330
SN - 0301-0449
VL - 53
SP - 2539
EP - 2551
JO - Pediatric Radiology
JF - Pediatric Radiology
IS - 12
ER -