The Importance of Diffusion ADC values in the Evaluation of Soft Tissue Sarcomas After Treatment

Congress:

ESSR 2018

Poster Number:

P-0005

Type:

Scientific Poster

Keywords:

Musculoskeletal soft tissue, Oncology, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Tissue characterisation, Cancer

Authors:

E. Aktas, M. Arikan, F. ARDIC, B. S. Sahin, J. karakaya, G. Togral, B. K. Arıbaş; Ankara/TR

DOI:

10.1594/essr2018/P-0005

DOI-Link:

https://dx.doi.org/10.1594/essr2018/P-0005

Table 1: Table 1: Comparison of Demographic Characteristics and Apparent Diffusion...

Table 2: Table 2: Area Under the Receiver Operating Characteristics Curve (AUC) and...

Fig. 1: Figure 1,2,3: In the MRI follow up of the 34 year old patient operated for a...

Fig. 2: Figure 1,2,3: In the MRI follow up of the 34 year old patient operated for a...

Purpose

Soft tissue sarcomas account for less than 1% of all adult malignities (1,2). Despite combined and aggressive treatment methods including radiotherapy, chemotherapy and surgical treatment local relapse rates of soft tissue sarcomas are between 535% (25). Most relapses develop within the first two years after surgery (3). For this reason, postoperative follow up must be done every 36 months with imaging. The lesion size, location, histological grade, the efficiency of surgical resection and response to adjuvant treatments are important risk factors for the development of...

Methods and Materials

Study population 56 patients who underwent surgery with the diagnosis of soft tissue sarcomas between June 2012 and March 2015 that were followed up with MRIs were evaluated. After the surgery, 5 patients with positive surgical margins and residual disease, 5 patients with lung metastases was detected in and 2 patients with a history of a second primary cancer (one was colon cancer, the other was papillary thyroid cancer) were excluded from the trial. In addition, two patients with a groin localized tumor and a...

Results

Recurrent tumors were identified in 15 of the 42 patients included in the study. Out of these patients 6 (40%) were female and 9 (60%) were male. Out of the 27 patients classified as postoperative tissue changes, 14 (51,8%) were women and 12 (48,1%) were male. There was no statistical difference in respect to gender between the two groups (p=0.183). The mean age of patients with recurrent tumors identified was 51,6±19,5 and the mean age of patients with postoperative tissue changes was 51,07± 1,37. No...

Conclusion

In our study, we identified that the ADC calculations obtained from diffusion weighted images at different b levels is highly sensitive and specific in the differentiation of soft tissue sarcoma recurrence and postoperative benign changes. Conventional MRI has an important role in the postoperative evaluation of soft tissue sarcomas. However, once patients are delivered radiotherapy and chemotherapy after surgical treatment, differentiating areas of posttreatment tissue changes from tumor recurrence can sometimes be difficult (2). Postoperative seromas, hematomas and inflammatory changes following radiotherapy are hyperintense in...

References

1. Landis SH, Wurray T, Bolden S, et al. Cancer statistics 1999. Cancer J Clin 1999; 49: 8_31. 2. James SL, Davies AM. Postoperative imaging of soft tissue sarcomas. Cancer Imaging. 2008 Feb 27;8:818. doi: 10.1102/14707330.2008.0003. Review. PubMed PMID: 18331968; PubMed Central PMCID: PMC2267691. 3. Potter DA, Glenn J, Kinsella T, et al. Patterns of recurrence in patients with highgrade soft tissue sarcomas. J Clin Oncol 1985;3: 353_66. 4. Lewis JJ, Leung D, Heslin M, et al. Association of local recurrence with subsequent survival in...