scholarly journals Diffusion-weighted MR imaging diagnostic merits in the post-therapeutic assessment of musculoskeletal soft tissue sarcoma

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Amr Farouk Ibrahim Moustafa ◽  
Shaimaa Shokry Mohammed Al Shahat El Said ◽  
Maged Abdelrahman Moustafa ◽  
Marwa Mahmoud Hussein ◽  
Ahmed Mohamed Shokry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Tumor Volume ◽  
Neoadjuvant Treatment ◽  
Evaluation Criteria ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
Progressive Group ◽  
Adc Values ◽  
Response Evaluation Criteria

Abstract Background 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. 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. Results ADC 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. Conclusion Quantitative 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.

Nivolumab plus ipilimumab for soft tissue sarcoma: a single institution retrospective review

Immunotherapy ◽  
2020 ◽  
Vol 12 (18) ◽  
pp. 1303-1312 ◽  
Author(s):  
Maggie Zhou ◽  
Nam Bui ◽  
Shreyana Bolleddu ◽  
Marta Lohman ◽  
Hans-Christoph Becker ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Solid Tumors ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
Response Evaluation ◽  
Advanced Soft Tissue Sarcoma ◽  
Response Evaluation Criteria

Aim: To analyze the efficacy of checkpoint inhibitors in soft tissue sarcoma. Materials & methods: We retrospectively reviewed patients with advanced soft tissue sarcoma treated with ipilimumab and nivolumab. All patients who received at least one cycle were included. Results: One patient had a complete response and five had a partial response, for an objective response rate of 15%. Clinical benefit rate was 34% with a median duration of 12.0 months (range: 4.5 to 28.9+ months [mo]). Median overall survival was 12.0 months (95% CI: 4.5–23.7+ mo). Median progression-free survival was 2.7 months (95% CI: 2.3–4.5+ mo) by Response Evaluation Criteria in Solid Tumors 1.1 and 2.9 months (2.5–6.0+ mo) by immune-related Response Evaluation Criteria in Solid Tumors. Adverse events of any grade were seen in 58% of patients, the most common being fatigue (21%) and cough (10%), 5% of patients experienced a grade 3 adverse event (AE) (hyperglycemia) or grade 4 AE (myocarditis). Conclusion: Ipilimumab/nivolumab combination showed efficacy and was well tolerated in advanced soft tissue sarcoma.

The evolving landscape of criteria for evaluating tumor response in the era of cancer immunotherapy: From Karnofsky to iRECIST

2018 ◽  
Vol 104 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Alessandro Inno ◽  
Giuseppe Lo Russo ◽  
Matteo Salgarello ◽  
Giulia Corrao ◽  
Raffaella Casolino ◽  
...  
Keyword(s):  
Tumor Response ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Therapy Response ◽  
Clinical Activity ◽  
Special Focus ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
New Anticancer Drugs ◽  
Response Evaluation Criteria

The objective response is an important endpoint to evaluate clinical activity of new anticancer drugs. Standardized criteria for evaluating response are needed for comparing results of different trials and represent the basis for advances in cancer therapy. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 are the most used in clinical practice and in clinical trials; however, they are not able to capture atypical responses seen with immunotherapy drugs. We describe the evolution of response criteria with a special focus on the immune-related criteria.

scholarly journals Multiparametric MRI with diffusion-weighted imaging in predicting response to chemotherapy in cases of osteosarcoma and Ewing’s sarcoma

2020 ◽  
Vol 93 (1115) ◽  
pp. 20200257
Author(s):  
Mahmoud Mohamed Saleh ◽  
Tamer Moustafa Abdelrahman ◽  
Youusef Madney ◽  
Ghada Mohamed ◽  
Ahmed Mohammed Shokry ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Tumor Volume ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Multiparametric Mri ◽  
Dce Mri ◽  
Recist 1.1 ◽  
Progressive Group ◽  
Adc Values ◽  
Modified Recist

Objective: To evaluate the multiparametric MRI in predicting chemotherapy response in pathologically proven cases of osteosarcoma and Ewing’s sarcoma. Correlation between the tumor size changes and internal breakdown using RECIST 1.1, modified RECIST, quantitative apparent diffusion coefficient (ADC) and tumor volume as well as dynamic contrast-enhanced MRI (DCE-MRI). Methods: The study included 104 patients pathologically proved osteosarcoma (53) and Ewing`s sarcoma (51) underwent MRI examinations; before and after chemotherapy. All patients were assessed using the RECIST 1.1 criteria, m-RECIST, quantitative ADC, and tumor volume evaluation. 21 patients underwent DCE-MRI curve type with quantitative parameters. Correlation between the different evaluations was carried out. Results were correlated with the post-operative pathology in 42 patients who underwent surgery and for statistical evaluation, Those patients were classified into responders (≥90% necrosis) and non-responders (<90% necrosis). Results: The initial mean ADC of 104 patients of osteosarcoma and Ewing’s sarcoma (0.90 ± 0.29) and (0.71 ± 0.16) respectively, differed significantly from that after treatment (1.62 ± 0.46) and (1.6 ± 0.39) respectively with (p<0.001). ADC variations (ADC%) in the non-progressive group were higher than those of the progressive group (128.3 ± 63.49 vs 36.34 ± 78.7) % with (p<0.001). ADC values and ADC variations were inversely correlated with morphologic changes, regardless of the effectiveness of chemotherapy expressed as changes in tumor size based on (RECIST 1.1, RECIST, and 3D volume). Linear regression analysis revealed a Pearson correlation coefficient of r=-0.427, -0.498 and -0.408, respectively with (p<0.001). An increase in the ADC value was not always associated with a reduction in tumor volume. The disease control rate (defined as the percentage of CR+PR+SD patients) was 89.4% and 93.9% according to RECIST 1.1 and m-RECIST respectively. 42 out of the 104 patients had postsurgical histological evaluation as regards the chemotherapeutic response divided into two groups. ADC values showed a statistically significant difference between Group A and Group B being more evident with minimum ADC% (p<0.001). Conclusion: Quantitative diffusion-weighted imaging with ADC mapping and ADC % after chemotherapy allows a detailed analysis of the treatment response in osteosarcoma and Ewing’s sarcoma. The therapeutic response can be underestimated using RECIST 1.1, so the modified RECIST should be also considered. Advances in knowledge: Quantitative ADC especially ADC% provided an accurate non-invasive tool in the assessment of post-therapeutic cases of osteosarcoma and Ewing's sarcoma

scholarly journals Plaučių navikų ilgosios ašies ir tūrių pokyčio palyginimas vertinant atsaką į gydymą

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Andrius Strazdas ◽  
Ignė Urbonavičiūtė ◽  
Jurgita Zaveckienė
Keyword(s):  
Evaluation Criteria ◽  
Solid Tumours ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
Response Evaluation Criteria

Plečiantis plaučių vėžio (PV) gydymo metodams ir galimybėms, kasdienėje klinikinėje praktikoje vis dažniau susiduriama su taikomų naviko atsako į gydymą vertinimo metodikų ribotumo ir tobulinimo klausimais. Standartizuota solidinių navikų atsako vertinimo metodika RECIST (angl. Response Evaluation Criteria in Solid Tumours) 1.1 ne visais atvejais gali užtikrinti ankstyvą progresuojančios ligos nustatymą. Tyrimo tikslas. Išanalizuoti išmatuojamų navikų matmenų ir tūrių pokyčių skirtumus, vertinant PV atsaką į gydymą kompiuterinės tomografijos (KT) vaizduose. Tyrimo metodai. Retrospektyviai įvertinti 2016–2019 m. įprastai atliktų KT tyrimų duomenys. Atrankos kriterijai: verifikuotas nesmulkių ląstelių PV, KT tyrimas atliktas prieš gydymą ir du KT tyrimai gydant; plaučiuose nustatytas bent vienas išmatuojamas navikinis darinys. Matuotas navikinio darinio ilgosios ašies matmuo (IA) ir tūris pagal elipsės (VT) ir sferos modelius (VS). Matavimai atlikti rankiniu ir pusiau automatiniu būdu, naudojant VitreaWorkstation™ CAD programinę įrangą. Dydžių pokyčiai vertinti remiantis RECIST 1.1 kategorijomis: progresuojanti liga (PL), dalinis atsakas ir stabili liga. Rezultatai. Tyrime analizuoti 125 pacientų duomenys. Išmatuoti 145 navikiniai dariniai ir įvertintas jų atsakas į gydymą. Nustatytas labai stiprus ryšys tarp IA ir VT prieš gydymą ir gydant (atitinkamai r=0,921, I r=0,937, II r=0,920). Vertinant VT pokyčius I ir II kontrolinių tyrimų vaizduose, PL nustatyta dažniau nei vertinant IA pokyčius, atitinkamai – 13,8 proc. ir 6,9 proc. Remiantis VT padidėjimu, I kontroliniame tyrime nustatytas PL dažnis 36,6 proc. (n=53) atitiko IA II kontroliniame tyrime nustatytą PL dažnį 35,9 proc. (n=52). Išvada. Nustatytas labai stiprus ryšys tarp naviko IA ir VT. Naviko VT padidėjimas gali būti jautresnis būdas įvertinti PL PV sergantiems pacientams.

Radiologisches Monitoring bei Immuntherapie des Nierenzellkarzinoms

2021 ◽  
Vol 52 (05) ◽  
pp. 474-480
Author(s):  
Simon Lennartz ◽  
Thorsten Persigehl
Keyword(s):  
Solid Tumors ◽  
Evaluation Criteria ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
Response Evaluation Criteria

ZusammenfassungIn der Radiologie stellen die Response Evaluation Criteria in Solid Tumors (RECIST 1.1) die aktuell am weitesten etablierten Bewertungskriterien für das standardisierte Therapiemonitoring bei soliden Tumoren von klassischen zytostatischen und zytotoxischen Tumortherapien dar. Der zunehmende Einsatz von Immuncheckpointinhibitoren in der Therapie des metastasierten Nierenzellkarzinoms stellt das radiologische Therapiemonitoring durch das Auftreten atypischer Ansprechmuster und immuntherapiespezifischer Nebenwirkungen vor besondere Herausforderungen. Hier können angepasste Kriterien, wie beispielsweise immune RECIST (iRECIST), bei der Verlaufsbeurteilung des Nierenzellkarzinoms helfen, sowohl innerhalb als auch außerhalb klinischer Studien atypische Verläufe unter Immuncheckpointinhibitortherapie zu erfassen.

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