Abstract:
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Purpose: To evaluate tumor response to high dose TNFα in locally advanced soft tissue sarcomas (ASTS) of the extremity in patients undergoing an ILP, assessed by Doppler-ultrasonography with perfusion software and contrast agent injection (UDPSCA).
Methods and Materials: Patients with ASTS were prospectively included in a monocentric imaging trial. Surgery of residual tumor masses was planned 2 months after ILP. UDPSCA was performed with a sonograph Aplio using software perfusion (Dynamic Flow, Toshiba) before ILP and on days 1, 7, 15, 30 and 60 after ILP. The percentage of uptake of contrast agent (Levovist, Schering) was evaluated at each tumor site by two radiologists. Results obtained by UDPSCA were compared to both MRI (planned on day 30 and 60) and pathological response.
Results: Up to date, among 64 patients treated at our institution by ILP, 124 UDPSCA were performed on 28 target lesions in 23 patients. Among the 22 patients who have had a complete evaluation, 14 were very good responders with a tumor necrosis of more than 80% at day 60 on MRI. For the early evaluation, a decrease in uptake of the contrast agent on day one was the best ultrasonographic criterion able to predict 13/14 good responders and 7/8 bad responders.
Conclusion: Decrease in uptake of contrast medium assessed by UDPSCA one day after ILP is correlated with a favorable histological response to high dose TNFα. UDPSCA, a new cheap and simple radiological non invasive technique, seems to be more accurate and predictive in evaluating histological response than both clinical examination and MRI in patients undergoing an ILP with high dose TNFα. Final results (50 patients) will be presented in December 2003.
Questions about this event email: lassau@igr.fr
Lassau MD, PhD, N,
Prospective Study of Doppler-Ultrasonography with Perfusion Software and Contrast Medium Injection as an Early Evaluation Tool of Isolated Limb Perfusion (ILP) of Limb Sarcomas. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3101233.html
