Diffusion-Weighted Imaging Prior to Percutaneous Sclerotherapy of Venous Malformations—Proof of Concept Study for Prediction of Clinical Outcome

Gerwing, Mirjam; Schindler, Philipp; Schneider, Kristian Nikolaus; Sundermann, Benedikt; Köhler, Michael; Stamm, Anna-Christina; Schmidt, Volker J.; Perkowski, Sybille; Deventer, Niklas; Heindel, Walter; Wildgruber, Moritz; Masthoff, Max

doi:10.3390/diagnostics12061430

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…For this purpose, no standardized protocol or guidelines/recommendations exist and the oncological RECIST criteria may not be the best option for assessing vascular malformations. In this regard, new functional imaging modalities and advanced analysis tools may prove more versatile for treatment response evaluation in the future ( 30 , 31 ). These aspects emphasize the general complexity in studying this rare disease, as there are currently no established criteria for the analysis of both clinical and objective response.…”

Section: Discussionmentioning

confidence: 99%

Multicentered analysis of percutaneous sclerotherapies in venous malformations of the face

et al. 2022

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ObjectivesTo evaluate the safety and outcome of image-guided sclerotherapy for treating venous malformations (VMs) of the face.Materials and methodsA multicenter cohort of 68 patients with VMs primarily affecting the face was retrospectively investigated. In total, 142 image-guided sclerotherapies were performed using gelified ethanol and/or polidocanol. Clinical and imaging findings were assessed to evaluate clinical response, lesion size reduction, and complication rates. Sub-analyses of complication rates depending on type and injected volume of the sclerosant as well as of pediatric versus adult patient groups were conducted.ResultsMean number of procedures per patient was 2.1 (±1.7) and mean follow-up consisted of 8.7 months (±6.8 months). Clinical response (n = 58) revealed a partial relief of symptoms in 70.7% (41/58), 13/58 patients (22.4%) presented symptom-free while only 4/58 patients (6.9%) reported no improvement. Post-treatment imaging (n = 52) revealed an overall objective response rate of 86.5% (45/52). The total complication rate was 10.6% (15/142) including 4.2% (7/142) major complications, mostly (14/15, 93.3%) resolved by conservative means. In one case, a mild facial palsy persisted over time. The complication rate in the gelified ethanol subgroup was significantly higher compared to polidocanol and to the combination of both sclerosants (23.5 vs. 6.0 vs. 8.3%, p = 0.01). No significant differences in complications between the pediatric and the adult subgroup were observed (12.1 vs. 9.2%, p = 0.57). Clinical response did not correlate with lesion size reduction on magnetic resonance imaging (MRI).ConclusionImage-guided sclerotherapy is effective for treating VMs of the face. Clinical response is not necessarily associated with size reduction on imaging. Despite the complex anatomy of this location, the procedures are safe for both adults and children.

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Section: Discussionmentioning

confidence: 99%

Multicentered analysis of percutaneous sclerotherapies in venous malformations of the face

et al. 2022

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“…They result from an abnormal connection between arteries and veins without a capillary bed in between [8][9][10], continuously expanding over time. Due to the fast-flow shunting, hemodynamic effects such as local hypervascularity, increased venous pressure, and steal phenomenon occur, which can result in peripheral ischemia distal to the malformation [1,11,12]. Thus, the patients may present with local pain, bleeding, hyperemia, ulceration, and gangrene up to high-output cardiac failure [13,14].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome and Quality of Life of Multimodal Treatment of Extracranial Arteriovenous Malformations: The APOLLON Study Protocol

Schmidt

Masthoff²,

Vielsmeier³

et al. 2022

Cardiovasc Intervent Radiol

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Purpose Arteriovenous malformations (AVMs) as rare diseases are diagnostically and therapeutically challenging. Due to the limited evidence regarding treatment outcome, prospective data are needed on how different treatment regimens affect outcome. The aims of this prospective trial are to determine effectiveness, safety, and clinical outcome of multimodal treatment in patients with extracranial AVMs. Materials and Methods After clinical and magnetic resonance imaging (MRI)-based diagnosis and informed consent, 146 patients (> 4 years and < 70 years) undergoing multimodal therapy in tertiary care vascular anomalies centers will be included in this prospective observational trial. Treatment options include conservative management, medical therapy, minimally invasive image-guided procedures (embolization, sclerotherapy) and surgery as well as combinations of the latter. The primary outcome is the patient-reported QoL 6 months after completion of treatment using the short form-36 health survey version 2 (SF-36v2) and the corresponding short form-10 health survey (SF-10) for children. In addition, clinical presentation (physician-reported signs), MRI imaging (radiological assessment of devascularization), recurrence rate, and therapeutic safety will be analyzed. Further follow-up will be performed after 12, 24, and 36 months. Moreover, liquid biopsies are being obtained from peripheral blood at multiple time points to investigate potential biomarkers for therapy response and disease progression. Discussion The APOLLON trial is a prospective, multicenter, observational open-label trial with unequal study groups to generate prospective evidence for multimodal treatment of AVMs. A multicenter design with the potential to assess larger populations will provide an increased understanding of multimodal therapy outcome in this orphan disease. Trial Registration German Clinical Trials Register (identification number: DRKS00021019) https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021019.

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Delta radiomics: an updated systematic review

Nardone,

Reginelli,

Rubini

et al. 2024

Radiol med

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Background Radiomics can provide quantitative features from medical imaging that can be correlated with various biological features and diverse clinical endpoints. Delta radiomics, on the other hand, consists in the analysis of feature variation at different acquisition time points, usually before and after therapy. The aim of this study was to provide a systematic review of the different delta radiomics approaches. Methods Eligible articles were searched in Embase, Pubmed, and ScienceDirect using a search string that included free text and/or Medical Subject Headings (MeSH) with 3 key search terms: 'radiomics,' 'texture,' and 'delta.' Studies were analyzed using QUADAS-2 and the RQS tool. Results Forty-eight studies were finally included. The studies were divided into preclinical/methodological (5 studies, 10.4%); rectal cancer (6 studies, 12.5%); lung cancer (12 studies, 25%); sarcoma (5 studies, 10.4%); prostate cancer (3 studies, 6.3%), head and neck cancer (6 studies, 12.5%); gastrointestinal malignancies excluding rectum (7 studies, 14.6%) and other disease sites (4 studies, 8.3%). The median RQS of all studies was 25% (mean 21% ± 12%), with 13 studies (30.2%) achieving a quality score < 10% and 22 studies (51.2%) < 25%. Conclusions Delta radiomics shows potential benefit for several clinical endpoints in oncology, such asdifferential diagnosis, prognosis and prediction of treatment response, evaluation of side effects. Nevertheless, the studies included in this systematic review suffer from the bias of overall low methodological rigor, so that the conclusions are currently heterogeneous, not robust and hardly replicable. Further research with prospective and multicenter studies is needed for the clinical validation of delta radiomics approaches.

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Diffusion-Weighted Imaging Prior to Percutaneous Sclerotherapy of Venous Malformations—Proof of Concept Study for Prediction of Clinical Outcome

Cited by 4 publications

References 36 publications

Multicentered analysis of percutaneous sclerotherapies in venous malformations of the face

Multicentered analysis of percutaneous sclerotherapies in venous malformations of the face

Clinical Outcome and Quality of Life of Multimodal Treatment of Extracranial Arteriovenous Malformations: The APOLLON Study Protocol

Delta radiomics: an updated systematic review

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