Dimensional assessment on baseline MRI of soft-tissue sarcomas: longest diameter, sum and product of diameters, and volume-which is the best measurement method to predict patients' outcomes?

IF 9.7 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiologia Medica Pub Date : 2024-10-18 DOI:10.1007/s11547-024-01895-8

Valerio D'Agostino, Federico Ponti, Claudia Martella, Marco Miceli, Andrea Sambri, Massimiliano De Paolis, Davide Maria Donati, Giuseppe Bianchi, Alessandra Longhi, Amandine Crombé, Paolo Spinnato

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引用次数: 0

Abstract

Purpose: The longest diameter (LD) is a strong prognostic factor for patients with soft-tissue sarcoma (STS). Other dimensional assessments, such as the sum of diameters (SoD), product of diameters (PoD), and volume (3D-COG - proposed by the Children Oncology Group), can be rapidly performed; however, their prognostic values have never been compared to LD. Our goal was to investigate their performance in improving patients' prognostication for STS of the lower limbs.

Methods: All consecutive adults managed with curative intent at our sarcoma reference center for a newly diagnosed STS of the lower limbs between 2000 and 2017, with pre-treatment MRI, were included in this retrospective study. Multivariable Cox regression models were trained to predict metastasis-free survival (MFS) in a Training cohort of 66.7% patients based on LD, PoD, SoD, or 3D-COG (and systematically including age, histologic grade, histotype, radiotherapy, chemotherapy, and surgical margins as covariables). The models were then compared on a validation cohort of 33.3% patients using concordance indices (c-index). The same approach was applied for overall survival (OS) and local relapse-free survival (LFS). Measurement reproducibility among three readers was evaluated with an intraclass correlation coefficient (ICC).

Results: 382 patients were included in the survival modeling (72/253 [28.5%] metastatic relapses in Training and 36/129 [27.9%] metastatic relapses in Validation). Higher dimensions were associated with lower MFS (multivariable hazard ratio [HR] = 2.44 and P = 0.0018 for LD; HR = 1.88 and P = 0.0009 for PoD, HR = 1.52 and P = 0.0041 for SoD; and HR = 1.08 and P = 0.0195 for 3D-COG). Higher c-indices were obtained with PoD model in Training (c-index = 0.772) and Validation (c-index = 0.688), but they were not significantly higher than those obtained with LD model. None of the measurements was associated with LFS or OS. All measurements demonstrated excellent ICC (> 0.95).

Conclusion: Regarding its simplicity and good performance, LD appeared as the best metric to incorporate in prognostic models and nomograms for MFS.

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软组织肉瘤基线磁共振成像的尺寸评估：最长直径、直径之和与积以及体积--哪种测量方法最能预测患者的预后？

目的：最长直径（LD）是软组织肉瘤（STS）患者的一个重要预后因素。其他尺寸评估，如直径总和（SoD）、直径乘积（PoD）和体积（3D-COG，由儿童肿瘤学组提出），也可以快速进行；但是，它们的预后价值从未与最长直径进行过比较。我们的目标是研究它们在改善下肢 STS 患者预后方面的性能：这项回顾性研究纳入了 2000 年至 2017 年间在我们的肉瘤参考中心接受治疗的所有连续成人新诊断下肢 STS 患者，这些患者在治疗前均接受了 MRI 检查。根据LD、PoD、SoD或3D-COG（并系统地将年龄、组织学分级、组织类型、放疗、化疗和手术切缘作为协变量）训练了多变量Cox回归模型，以预测66.7%患者的训练队列中的无转移生存期（MFS）。然后使用一致性指数（c-index）在 33.3% 患者的验证队列中对模型进行比较。同样的方法也适用于总生存期（OS）和局部无复发生存期（LFS）。使用类内相关系数（ICC）评估了三位读者的测量重现性：382名患者被纳入生存期建模（72/253 [28.5%]例转移性复发患者被纳入训练，36/129 [27.9%]例转移性复发患者被纳入验证）。较高的维度与较低的 MFS 相关（LD 的多变量危险比 [HR] = 2.44，P = 0.0018；PoD 的 HR = 1.88，P = 0.0009；SoD 的 HR = 1.52，P = 0.0041；3D-COG 的 HR = 1.08，P = 0.0195）。在训练（c-index = 0.772）和验证（c-index = 0.688）中，PoD 模型获得了较高的 c-index，但并没有明显高于 LD 模型获得的 c-index。所有测量结果均与 LFS 或 OS 无关。所有测量结果均显示出极佳的ICC（> 0.95）：结论：LD模型简单、性能良好，是纳入MFS预后模型和提名图的最佳指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.