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Chemotherapy response evaluation using diffusion weighted MRI in Ewing Sarcoma: A single center experience.

Esha Baidya Kayal1, Jayendra Tiru Alampally2, Raju Sharma3

  • 1Centre for Biomedical Engineering, 28817Indian Institute of Technology Delhi, New Delhi, India.

Acta Radiologica (Stockholm, Sweden : 1987)
|September 8, 2022
PubMed
Summary

Normalized ADC (nADC) and its change after the first chemotherapy cycle show promise as non-invasive biomarkers for early detection of treatment response in Ewing sarcoma family of tumors (ESFT). These MRI-derived metrics can help optimize treatment protocols.

Keywords:
ChemotherapyEwing sarcomabiomarkerdiffusion-weighted magnetic resonance imagingtreatment outcome assessment

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Area of Science:

  • Oncology
  • Radiology
  • Biomarkers

Background:

  • Early assessment of chemotherapeutic response in Ewing sarcoma family of tumors (ESFT) is crucial for treatment optimization.
  • Non-invasive biomarkers are needed to monitor treatment efficacy in ESFT patients.

Purpose of the Study:

  • To evaluate the utility of diffusion-weighted magnetic resonance imaging (MRI) for early prediction of chemotherapeutic response in ESFT.
  • To assess the role of apparent diffusion coefficient (ADC) and normalized ADC (nADC) in monitoring treatment response.

Main Methods:

  • Prospective analysis of 28 ESFT patients undergoing 1.5-T MRI at baseline, after the first chemotherapy cycle, and at the end of treatment.
  • Tumor diameter, ADC, and nADC values were measured and analyzed.
  • RECIST 1.1 criteria were used to categorize patients into responders and non-responders.

Main Results:

  • Baseline nADC was significantly lower in responders compared to non-responders (P=0.033), with an AUC of 0.735 for predicting response.
  • After the first chemotherapy cycle, responders showed a significantly greater reduction in tumor diameter (P=0.002) and a higher increase in ADC (P=0.039) and nADC (P=0.008) compared to non-responders.
  • Changes in tumor diameter, ADC, and nADC after the first cycle demonstrated high accuracy (AUCs 0.890, 0.723, 0.756) in identifying chemotherapy response.

Conclusions:

  • Baseline nADC can serve as a non-invasive marker for predicting early chemotherapeutic response in ESFT.
  • Changes in nADC after the first chemotherapy cycle are valuable surrogate markers for early treatment response assessment in ESFT patients.