ACR Appropriateness Criteria Follow-Up of Malignant or Aggressive Musculoskeletal Tumors

Roberts, Catherine C.; Kransdorf, Mark J.; Beaman, Francesca D.; Adler, Ronald S.; Amini, Behrang; Appel, Marc; Bernard, Stephanie A.; Fries, Ian Blair; Germano, Isabelle M.; Greenspan, Bennett S.; Holly, Langston T.; Kubicky, Charlotte Dai; Lo, Simon S.; Mosher, Timothy J.; Sloan, Andrew E.; Tuite, Michael J.; Walker, E. Ronald; Ward, Robert James; Wessell, Daniel E.; Weissman, Barbara N.

doi:10.1016/j.jacr.2015.12.019

Cited by 54 publications

(52 citation statements)

References 76 publications

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“…However, data informing the appropriate use of MRI in the surveillance setting are conflicting 5,8,9. Indeed, MRI can differentiate local recurrence from post-surgical seroma, hematoma, inflammation and scarring, but some post-operative changes in the surgical bed can be similar to those of recurrence with conventional T1-weighted, T2- weighted, and post-contrast sequences posing diagnostic dilemmas especially when sarcoma recurrence has low signal intensity on fluid-sensitive images 1,8, 9, 10, 11. We hypothesized that radiomics analysis of MRI of patients undergoing follow-up for STS allows to differentiate normal tissue from pathological tissue of LR.…”

Section: Introductionmentioning

confidence: 99%

Local recurrence of soft tissue sarcoma: a radiomic analysis

Tagliafico

Bignotti

Rossi

et al. 2019

Radiology and Oncology

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Background To perform a radiomics analysis in local recurrence (LR) surveillance of limb soft tissue sarcoma (STS) Patients and methods This is a sub-study of a prospective multicenter study with Institutional Review Board approval supported by ESSR (European Society of Musculoskeletal Radiology). radiomics analysis was done on fast spin echo axial T1w, T2w fat saturated and post-contrast T1w (T1wGd) 1.5T MRI images of consecutively recruited patients between March 2016 and September 2018. Results N = 11 adult patients (6 men and 5 women; mean age 57.8 ± 17.8) underwent MRI to exclude STS LR: a total of 33 follow-up events were evaluated. A total of 198 data-sets per patients of both pathological and normal tissue were analyzed. Four radiomics features were significantly correlated to tumor size (p < 0.02) and four radiomics features were correlated with grading (p < 0.05). ROC analysis showed an AUC between 0.71 (95%CI: 0.55–0.87) for T1w and 0.96 (95%CI: 0.87–1.00) for post-contrast T1w. Conclusions radiomics features allow to differentiate normal tissue from pathological tissue in MRI surveillance of local recurrence of STS. radiomics in STS evaluation is useful not only for detection purposes but also for lesion characterization.

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Section: Introductionmentioning

confidence: 99%

Local recurrence of soft tissue sarcoma: a radiomic analysis

Tagliafico

Bignotti

Rossi

et al. 2019

Radiology and Oncology

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“…For myxoid liposarcoma, for which PET/CT has a high false-negative rate in detecting LR, 70 follow-up with wholebody MRI was advocated. 84 In PET-avid soft tissue sarcomas, PET/MR is promising in detecting LR when compared with MRI alone.…”

Section: Imaging Strategies For Follow-upmentioning

confidence: 99%

“…128 A posttherapeutic baseline examination after 6 to 8 weeks therefore seems sensible, so immediate florid post-therapeutic changes can somewhat subside. 70 The ADC is known to depend heavily on the tissue composition. Moreover, absolute values are highly machine dependent.…”

Section: Appearance Of Local Recurrences and Radiation-associated Sarmentioning

confidence: 99%

“…82 According to a study, PET/CT is comparable in sensitivity (95% PET/CT versus 90% MRI) and specificity (95.5% versus 97.7%) in the detection of recurrence and therefore may act as an adjunct to MRI findings. 77 It may be justified in regions such as the retroperitoneum or in the ear, nose, and throat area if the initial tumor was PET avid, 70,83 simultaneously offering the advantage of showing distant metastases.…”

Section: Imaging Strategies For Follow-upmentioning

confidence: 99%

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Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence

Nöebauer-Huhmann

Chaudhary

Papakonstantinou

et al. 2020

Semin Musculoskelet Radiol

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Soft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations. Prerequisite is a precise knowledge of the current clinical management and surgical techniques. We review recurrence rates and treatment modalities. An adequate imaging technique is paramount, and comparison with previous imaging is highly recommended. We describe time-dependent therapy-related complications on magnetic resonance imaging compared with the spectrum of regular post-therapeutic changes. Early complications such as seromas, hematomas, and infections, late complications such as edema and fibrosis, and inflammatory pseudotumors are elucidated. The appearance of recurrences and radiation-associated sarcomas is contrasted with these changes. This systematic approach in follow-up imaging of soft tissue sarcoma patients will facilitate the differentiation of post-therapeutic changes from recurrences.

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“…For MM, the interpretation of bony lesion is straightforward in most cases due to the fact that lesions are lytic. However, in some cases, lesion could be numerous, well circumscribed and could punch out lucencies, raindrop skull, endosteal scalloping and sometimes generalized osteopenia [25,26]. In these cases, it is likely that a sub-speciality with experience in reading CT and MRI data will enhance the role of CT and MRI for MM [27,28].…”

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confidence: 99%

Quantitative Imaging and Radiomics in Multiple Myeloma: opportunity or hype?

Tagliafico¹,

Dominietto²,

Belgioia³

et al. 2020

Preprint

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Multiple Myeloma (MM) is the second most common type of hematological disease and, although it is rare among patients under 40 years of age, its incidence rises in elderly subject. MM manifestations are usually known with the abbreviation CRAB (hyperCalcemia, Renal failure, Anaemia, and lytic Bone lesions). In particular, the extent of the bone disease is negatively related to a decreased patients’ quality of life and, in general, bone disease in MM increases both morbidity and mortality. The detection of lytic bone lesions on imaging, especially CT and MRI, is becoming crucial from the clinical viewpoint to separate asymptomatic from symptomatic MM patients and the detection of focal lytic lesion in these imaging data is becoming relevant even when no clinical symptoms are present. Therefore, radiology is pivotal in the staging and accurate management of patients with MM even in early phases of the disease. In this review we describe the opportunities offered by quantitative imaging and radiomics in multiple myeloma. At present time there is still high variability in the choice between various imaging methods to study MM patients and high variability in image interpretation with suboptimal agreement among readers even in tertiary centres. Therefore, the potential of medical imaging for patients affected by MM is still to be completely unveiled. In the next years, new insights to study MM with medical imaging will derive from artificial intelligence (AI) and radiomics usage in different bone lesions and from the wide implementations of quantitative methods to report CT and MRI. Eventually, medical imaging data can be integrated with the patient's outcomes with the purpose to find radiological biomarkers for predicting the disease prognostic flow and its therapeutic response.

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ACR Appropriateness Criteria Follow-Up of Malignant or Aggressive Musculoskeletal Tumors

Cited by 54 publications

References 76 publications

Local recurrence of soft tissue sarcoma: a radiomic analysis

Local recurrence of soft tissue sarcoma: a radiomic analysis

Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence

Quantitative Imaging and Radiomics in Multiple Myeloma: opportunity or hype?

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