Display options
Share it on

Eur Radiol. 2003 Aug;13(8):1849-58. doi: 10.1007/s00330-002-1785-4. Epub 2003 Jan 08.

Dynamic contrast-enhanced MR imaging in monitoring response to isolated limb perfusion in high-grade soft tissue sarcoma: initial results.

European radiology

Catherina S P van Rijswijk, Maartje J A Geirnaerdt, Pancras C W Hogendoorn, Johannes L Peterse, Frits van Coevorden, Antonie H M Taminiau, Rob A E M Tollenaar, Bin B R Kroon, Johan L Bloem

Affiliations

  1. Department of Radiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. [email protected]

PMID: 12942285 DOI: 10.1007/s00330-002-1785-4

Abstract

The objective of this study was to evaluate whether dynamic contrast-enhanced MR imaging can determine tumor response and localize residual viable tumor after isolated limb perfusion (ILP) chemotherapy in soft tissue tumors. Twelve consecutive patients, with histologically proven high-grade soft tissue sarcoma, prospectively underwent non-enhanced MR and dynamic contrast-enhanced MR imaging before and after ILP. Tumor volume was measured on non-enhanced MR images. The temporal change of signal intensity in a region of interest on dynamic contrast-enhanced MR images was plotted against time. Start, pattern, and progression of enhancement were recorded. Histopathologic response was defined as complete response if no residual viable tumor was present, partial remission if <50% viable tumor was present, and no change if > or =50% viable tumor was present in the resection specimen. Resected specimens for correlation with histopathology were available for 10 patients; 5 patients had partial remission and 5 had no change. Volume measurements correctly predicted tumor response in 6 of 10 patients. Dynamic contrast-enhanced MR correctly predicted tumor response in 8 of 10 patients. Early rapidly progressive enhancement correlated histologically with residual viable tumor. Late and gradual, or absence of enhancement, was associated with necrosis, predominantly centrally located, or granulation tissue. These preliminary results show that dynamic contrast-enhanced MR imaging offers potential for non-invasive monitoring of response to isolated limb perfusion in soft tissue sarcomas due to identification of residual areas of viable tumor and subsequently may provide clinically useful information with regards to timing and planning of additional surgery. Further prospective studies in a larger patient population is warranted.

References

  1. Med Pediatr Oncol. 1996 May;26(5):329-33 - PubMed
  2. Cancer. 1976 Jul;38(1):388-94 - PubMed
  3. Surgery. 1966 Oct;60(4):938-47 - PubMed
  4. NMR Biomed. 1995 Aug;8(5):215-24 - PubMed
  5. Int J Cancer. 1994 Jun 1;57(5):656-63 - PubMed
  6. Eur Radiol. 1998;8(4):517-27 - PubMed
  7. Eur J Surg Oncol. 2000 Apr;26(3):213-21 - PubMed
  8. Ann Surg. 1996 Dec;224(6):756-64; discussion 764-5 - PubMed
  9. Semin Musculoskelet Radiol. 1999;3(2):101-114 - PubMed
  10. Invest Radiol. 1992 Nov;27(11):989-91 - PubMed
  11. N Engl J Med. 1971 Nov 18;285(21):1182-6 - PubMed
  12. Radiology. 1998 Sep;208(3):821-8 - PubMed
  13. Radiology. 1994 Sep;192(3):835-43 - PubMed
  14. Radiology. 1991 Nov;181(2):398-400 - PubMed
  15. Ann Surg Oncol. 1997 Jan;4(1):64-9 - PubMed
  16. Magn Reson Med. 1992 Oct;27(2):226-37 - PubMed
  17. Eur Radiol. 2000;10(2):213-23 - PubMed
  18. AJR Am J Roentgenol. 1995 Sep;165(3):593-8 - PubMed
  19. Acad Radiol. 2000 Oct;7(10):812-23 - PubMed
  20. J Nucl Med. 1996 Jun;37(6):984-90 - PubMed
  21. Cancer. 2002 Mar 1;94(5):1557-64 - PubMed
  22. J Clin Oncol. 1992 Jan;10(1):52-60 - PubMed
  23. Radiology. 1990 Jun;175(3):791-6 - PubMed
  24. Magn Reson Imaging. 2000 Jun;18(5):525-35 - PubMed
  25. J Nucl Med. 1999 Feb;40(2):262-7 - PubMed
  26. Radiology. 1992 Jul;184(1):243-8 - PubMed
  27. J Clin Oncol. 1996 Oct;14(10):2653-65 - PubMed
  28. Br J Radiol. 1993 Mar;66(783):181-96 - PubMed
  29. J Nucl Med. 1996 Sep;37(9):1438-44 - PubMed
  30. Clin Orthop Relat Res. 2002 Apr;(397):212-27 - PubMed
  31. Invest Radiol. 1992 May;27(5):367-73 - PubMed
  32. Radiology. 1993 Mar;186(3):904-5 - PubMed
  33. J Magn Reson Imaging. 1999 Dec;10(6):903-7 - PubMed
  34. J Clin Oncol. 1993 May;11(5):1005 - PubMed
  35. Radiology. 1989 Mar;170(3 Pt 1):839-42 - PubMed
  36. J Magn Reson Imaging. 1995 Nov-Dec;5(6):689-94 - PubMed
  37. Ann Surg Oncol. 2000 Mar;7(2):155-9 - PubMed
  38. Cancer. 1993 Nov 1;72(9):2593-601 - PubMed

Substances

MeSH terms

Publication Types