Dataset Information

Investigating the role of functional imaging in the management of soft-tissue sarcomas of the extremities.

ABSTRACT:

Background and purpose

In this work, we validate a texture-based model computed from positron emission tomography (PET) and magnetic resonance imaging (MRI) for the prediction of lung metastases in soft-tissue sarcomas (STS). We explore functional imaging at different treatment time points and evaluate the feasibility of radiotherapy dose painting as a potential treatment strategy for patients with higher metastatic risk.

Materials and methods

We acquired fluorodeoxyglucose (FDG)-PET, fluoromisonidazole (FMISO)-PET, diffusion weighting (DW)-MRI and dynamic contrast enhanced (DCE)-MRI data for 18 patients with extremity STS before, during, and after pre-operative radiotherapy. We tested the lung metastases prediction model using pre-treatment images. We evaluated the feasibility of dose painting using volumetric arc therapy (VMAT) via treatment re-planning with a prescription of 50?Gy to the planning target volume (PTV_50Gy) and boost doses of 60?Gy to the FDG hypermetabolic gross tumour volume (GTV_60Gy) and 65?Gy to the low-perfusion DCE-MRI hypoxic GTV contained within the GTV_60Gy (GTV_65Gy).

Results

The texture-based model for lung metastases prediction reached an area under the curve (AUC), sensitivity, specificity and accuracy of 0.71, 0.75, 0.85 and 0.82, respectively. Dose painting resulted in adequate coverage and homogeneity in the re-planned treatments: D_95% to the PTV_50Gy, GTV_60Gy and GTV_65Gy were 50.0?Gy, 60.3?Gy and 65.4?Gy, respectively.

Conclusions

Textural biomarkers extracted from FDG-PET and MRI could be useful to identify STS patients that might benefit from dose escalation. The feasibility of treatment planning with double boost levels to intratumoural GTV functional sub-volumes was established.

SUBMITTER: Vallieres M

PROVIDER: S-EPMC7807871 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Publications

Investigating the role of functional imaging in the management of soft-tissue sarcomas of the extremities.

Vallières Martin M Serban Monica M Benzyane Ibtissam I Ahmed Zaki Z Xing Shu S El Naqa Issam I Levesque Ives R IR Seuntjens Jan J Freeman Carolyn R CR

Physics and imaging in radiation oncology 20180401

<h4>Background and purpose</h4>In this work, we validate a texture-based model computed from positron emission tomography (PET) and magnetic resonance imaging (MRI) for the prediction of lung metastases in soft-tissue sarcomas (STS). We explore functional imaging at different treatment time points and evaluate the feasibility of radiotherapy dose painting as a potential treatment strategy for patients with higher metastatic risk.<h4>Materials and methods</h4>We acquired fluorodeoxyglucose (FDG)- ...[more]

PMID: 33458389

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Project description:Soft tissue sarcomas (STS) are rare tumours arising in mesenchymal tissues, and can occur almost anywhere in the body. Their rarity, and the heterogeneity of subtype and location means that developing evidence-based guidelines is complicated by the limitations of the data available. However, this makes it more important that STS are managed by teams, expert in such cases, to ensure consistent and optimal treatment, as well as recruitment to clinical trials, and the ongoing accumulation of further data and knowledge. The development of appropriate guidance, by an experienced panel referring to the evidence available, is therefore a useful foundation on which to build progress in the field. These guidelines are an update of the previous version published in 2010 (Grimer et al. in Sarcoma 2010:506182, 2010). The original guidelines were drawn up following a consensus meeting of UK sarcoma specialists convened under the auspices of the British Sarcoma Group (BSG) and were intended to provide a framework for the multidisciplinary care of patients with soft tissue sarcomas. This current version has been updated and amended with reference to other European and US guidance. There are specific recommendations for the management of selected subtypes of disease including retroperitoneal and uterine sarcomas, as well as aggressive fibromatosis (desmoid tumours) and other borderline tumours commonly managed by sarcoma services. An important aim in sarcoma management is early diagnosis and prompt referral. In the UK, any patient with a suspected soft tissue sarcoma should be referred to one of the specialist regional soft tissues sarcoma services, to be managed by a specialist sarcoma multidisciplinary team. Once the diagnosis has been confirmed using appropriate imaging, plus a biopsy, the main modality of management is usually surgical excision performed by a specialist surgeon. In tumours at higher risk of recurrence or metastasis pre- or post-operative radiotherapy should be considered. Systemic anti-cancer therapy (SACT) may be utilized in some cases where the histological subtype is considered more sensitive to systemic treatment. Regular follow-up is recommended to assess local control, development of metastatic disease, and any late-effects of treatment. For local recurrence, and more rarely in selected cases of metastatic disease, surgical resection would be considered. Treatment for metastases may include radiotherapy, or systemic therapy guided by the sarcoma subtype. In some cases, symptom control and palliative care support alone will be appropriate.

Dataset Information

Investigating the role of functional imaging in the management of soft-tissue sarcomas of the extremities.

Background and purpose

Materials and methods

Results

Conclusions

Publications

Investigating the role of functional imaging in the management of soft-tissue sarcomas of the extremities.

Similar Datasets

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