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Comparing apparent diffusion coefficient and FNCLCC grading to improve pretreatment grading of soft tissue sarcoma: a translational feasibility study on fusion imaging

Histological subtype and grading are cornerstones of treatment decisions in soft tissue sarcoma (STS). Due to intratumoral heterogeneity, pretreatment grading assessment is frequently unreliable and may be improved through functional imaging. In this pilot study, 12 patients with histologically conf...

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Main Authors: Hettler, Madelaine (Author) , Kitz, Julia (Author) , Seif Amir Hosseini, Ali (Author) , Guhlich, Manuel (Author) , Panahi, Babak (Author) , Ernst, Jennifer (Author) , Conradi, Lena-Christin (Author) , Ghadimi, Michael (Author) , Ströbel, Philipp (Author) , Jakob, Jens (Author)
Format: Article (Journal)
Language:English
Published: 5 September 2022
In: Cancers
Year: 2022, Volume: 14, Issue: 17, Pages: 1-13
ISSN:2072-6694
DOI:10.3390/cancers14174331
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers14174331
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/14/17/4331
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Author Notes:Madelaine Hettler, Julia Kitz, Ali Seif Amir Hosseini, Manuel Guhlich, Babak Panahi, Jennifer Ernst, Lena-Christin Conradi, Michael Ghadimi, Philipp Ströbel and Jens Jakob
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Summary:Histological subtype and grading are cornerstones of treatment decisions in soft tissue sarcoma (STS). Due to intratumoral heterogeneity, pretreatment grading assessment is frequently unreliable and may be improved through functional imaging. In this pilot study, 12 patients with histologically confirmed STS were included. Preoperative functional magnetic resonance imaging was fused with a computed tomography scan of the resected specimen after collecting core needle biopsies and placing radiopaque markers at distinct tumor sites. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading criteria of the biopsies and apparent diffusion coefficients (ADCs) of the biopsy sites were correlated. Concordance in grading between the specimen and at least one biopsy was achieved in 9 of 11 cases (81.8%). In 7 of 12 cases, fusion imaging was feasible without relevant contour deviation. Functional analysis revealed a tendency for high-grade regions (Grade 2/3 (G2/G3)) (median (range) ± standard deviation: 1.13 (0.78-1.70) ± 0.23 × 10−3 mm2/s) to have lower ADC values than low-grade regions (G1; 1.43 (0.64-2.03) ± 0.46 × 10−3 mm2/s). In addition, FNCLCC scoring of multiple tumor biopsies proved intratumoral heterogeneity as expected. The ADC appears to correlate with the FNCLCC grading criteria. Further studies are needed to determine whether functional imaging may supplement histopathological grading.
Item Description:Gesehen am 25.0.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers14174331

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