Multiparametric assessment of high-grade pediatric soft-tissue sarcomas with anatomic and functional MRI sequences: a retrospective study.

IF 2.2 3区医学 Q2 ORTHOPEDICS

Skeletal Radiology Pub Date : 2025-09-08 DOI:10.1007/s00256-025-05025-x

Paulo de Tarso Kawakami Perez, Laura Marie Fayad, Mariana Batista Rosa Pinto, Henrique Manoel Lederman, Eliana Maria Monteiro Caran, Carla Renata Pacheco Donato Macedo, Julio Brandão Guimarães

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引用次数: 0

Abstract

Objective: To evaluate multiparametric MRI features of pediatric soft-tissue sarcomas, comparing pre-treatment and post-treatment features, and assessing correlation with clinical outcomes.

Materials and methods: Retrospective cohort study, including pediatric patients (≤ 18 years) with histologically-confirmed soft-tissue sarcomas who underwent MRI with anatomic and functional sequences in consecutive series. Post-treatment MRI was available for a subset, and features were recorded by two readers. Pre-treatment and post-treatment features were compared using Wilcoxon signed-rank test with Hodges-Lehmann estimator. Inter-reader agreement was assessed with intraclass correlation coefficient, and Mann-Whitney and Cox regression tests were used to correlate the features with clinical outcome.

Results: There were 27 patients. Pre-treatment we measured tumor size, ADCminimum (mean: 507 × 10-6mm²/s) and ADCaverage (mean: 690 × 10-6mm²/s). Post-treatment (10 patients) included a reduction in tumor size (p = 0.002) and higher ADCminimum (mean: 1116 × 10-6mm²/s) and ADCaverage (mean: 1344 × 10-6mm²/s) values. Pre-treatment size was larger in patients with metastasis at baseline (p = 0.004) and progression (p = 0.002), but size change after treatment did not correlate with progression. Baseline ADC did not correlate with progression, but the group with progression showed less difference between pre- and post-treatment ADCminimum (p = 0.019) and ADCaverage (p = 0.032). There was excellent agreement between the readers measuring ADCminimum (ICC = 0.991) and ADCaverage (ICC = 0.978).

Conclusion: For high-grade pediatric soft-tissue sarcomas, the pre-treatment size is an important prognostic factor, and a reduction in tumor size was observed after treatment, but did not correlate with progression. However, changes to ADC values between pre-treatment and post-treatment MRI correlated with disease progression, suggesting that ADC is a potentially useful biomarker of clinical outcome.

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用解剖和功能MRI序列对高级别儿童软组织肉瘤的多参数评估：一项回顾性研究。

目的：评价小儿软组织肉瘤的多参数MRI特征，比较治疗前和治疗后的特征，并评估与临床结局的相关性。材料与方法：回顾性队列研究，纳入连续系列经组织学证实的小儿软组织肉瘤患者（≤18岁），行MRI解剖和功能序列检查。治疗后对一部分患者进行MRI检查，并由两名读卡器记录特征。采用Wilcoxon sign -rank检验和Hodges-Lehmann估计量比较处理前后特征。使用类内相关系数评估读者间一致性，使用Mann-Whitney和Cox回归检验将特征与临床结果关联起来。结果：27例患者。治疗前测量肿瘤大小、ADCminimum（平均值：507 × 10-6mm2/s）和adaverage（平均值：690 × 10-6mm2/s）。治疗后（10例患者）肿瘤大小减小（p = 0.002）， ADCminimum（平均值：1116 × 10-6mm2/s）和adaverage（平均值：1344 × 10-6mm2/s）值升高。在基线转移（p = 0.004）和进展（p = 0.002）的患者中，治疗前的大小变化较大，但治疗后的大小变化与进展无关。基线ADC与进展无关，但进展组治疗前后ADCminimum （p = 0.019）和adaverage （p = 0.032）差异较小。读者测量ADCminimum （ICC = 0.991）和adaverage （ICC = 0.978）之间有极好的一致性。结论：对于高级别儿童软组织肉瘤，治疗前肿瘤大小是一个重要的预后因素，治疗后肿瘤大小减小，但与进展无关。然而，治疗前和治疗后MRI ADC值的变化与疾病进展相关，表明ADC是临床结果的潜在有用生物标志物。

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

Skeletal Radiology 医学-核医学

CiteScore

4.40

自引率

9.50%

发文量

253

审稿时长

3-8 weeks

期刊介绍： Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.