Antonella Messina MD, Presenter: Nothing to Disclose

Silvia Stacchiotti, Abstract Co-Author: Nothing to Disclose

Paola Collini MD, Abstract Co-Author: Nothing to Disclose

Paolo Casali MD, Abstract Co-Author: Nothing to Disclose

Alessandro Gronchi MD, Abstract Co-Author: Nothing to Disclose

Carlo Morosi MD, Abstract Co-Author: Nothing to Disclose

Federica Grosso MD, Abstract Co-Author: Nothing to Disclose

Francesca Salvaderi MD, Abstract Co-Author: Nothing to Disclose

Daniele Vergnaghi MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To correlate radiological MRI and pathological patterns of tumor response to preoperative chemo and radiation therapy in localized high-grade soft tissue sarcomas (STS).

40 pts with localized high-risk STS were treated with chemotherapy and radiotherapy, followed by surgery. MR examinations were performed before and after the neoadjuvant treatment with a 1.5T system using TSE T2w, TSE T1w and dynamic ce 3D-GRE T1w sequences. Ce 3D-GRE T1w images were evaluated before and after digital substraction. All data sets were qualitatively and quantitatively (time/intensity curves) evaluated. Radiologically, changes in tumor size according to RECIST criteria, tissue characteristics and contrast enhancement variations were evaluated. Histologically, the percentage of residual tumor throughout the whole mass was scored according to the FNCLCC pretreatment grading system (0, 50) and the quality and quantity of post-treatment changes (necrosis, hemorrhage and sclerohyalinosis) were evaluated.

On morphologic dimensional evaluation, 16/40 pts had a RECIST “Partial Response”, 24/40 pts had a RECIST “Stable/Progression desease”. 11/24 (45%) of the pts with RECIST “Stable/Progression desease” showed 5% mean contrast enhancement reduction on ce MR images and more than 50% of residual tumour on pathological evaluation, confirming the RECIST stability/progression of the disease. 13/24 (55%) of the pts with RECIST “Stable/Progression Desease” showed 55% mean contrast enhancement reduction on ce MR images and less than 50% of residual tumour on pathological evaluation (less than 30% in 11), with partial response to therapy.

Through the morphologic RECIST criteria, we were able to appreciate only a portion of pathologically responsive patients. The assessment of vascularization on MR imaging may usefully integrate the dimensional data, in order to clinically predict the pathologic tumor response.

MRI is an effective technique in the follow-up of localized high-grade STS. The assessment of vascularization on MR may integrate the RECIST criteria, in order to clinically predict the tumor response

Messina, A, Stacchiotti, S, Collini, P, Casali, P, Gronchi, A, Morosi, C, Grosso, F, Salvaderi, F, Vergnaghi, D, et al, , et al, , Preoperative Chemoradiation Therapy in Localized Soft Tissue Sarcoma (STS): Correlation between Radiological MRI and Pathological Patterns to Predict Pathologic Tumor Response.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015945.html