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Dynamic contrast-enhanced MR imaging in monitoring response to isolated limb perfusion in high-grade soft tissue sarcoma: initial results

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Abstract

The objective of this study was to evaluate whether dynamic contrast-enhanced MR imaging can determine tumor response and localize residual viable tumor after isolated limb perfusion (ILP) chemotherapy in soft tissue tumors. Twelve consecutive patients, with histologically proven high-grade soft tissue sarcoma, prospectively underwent non-enhanced MR and dynamic contrast-enhanced MR imaging before and after ILP. Tumor volume was measured on non-enhanced MR images. The temporal change of signal intensity in a region of interest on dynamic contrast-enhanced MR images was plotted against time. Start, pattern, and progression of enhancement were recorded. Histopathologic response was defined as complete response if no residual viable tumor was present, partial remission if <50% viable tumor was present, and no change if ≥50% viable tumor was present in the resection specimen. Resected specimens for correlation with histopathology were available for 10 patients; 5 patients had partial remission and 5 had no change. Volume measurements correctly predicted tumor response in 6 of 10 patients. Dynamic contrast-enhanced MR correctly predicted tumor response in 8 of 10 patients. Early rapidly progressive enhancement correlated histologically with residual viable tumor. Late and gradual, or absence of enhancement, was associated with necrosis, predominantly centrally located, or granulation tissue. These preliminary results show that dynamic contrast-enhanced MR imaging offers potential for non-invasive monitoring of response to isolated limb perfusion in soft tissue sarcomas due to identification of residual areas of viable tumor and subsequently may provide clinically useful information with regards to timing and planning of additional surgery. Further prospective studies in a larger patient population is warranted.

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Authors and Affiliations

  1. Department of Radiology, Leiden University Medical Center, 2300 RC , Leiden, The Netherlands

    Catherina S. P. van Rijswijk & Johan L. Bloem

  2. Department of Radiology, Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX, Amsterdam, The Netherlands

    Maartje J. A. Geirnaerdt

  3. Department of Pathology, Leiden University Medical Center, 2300 RC , Leiden, The Netherlands

    Pancras C. W. Hogendoorn

  4. Department of Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX, Amsterdam, The Netherlands

    Johannes L. Peterse

  5. Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX, Amsterdam, The Netherlands

    Frits van Coevorden & Bin B. R. Kroon

  6. Department of Orthopedic Surgery, Leiden University Medical Center, 2300 RC , Leiden, The Netherlands

    Antonie H. M. Taminiau

  7. Department of Surgery, Leiden University Medical Center, 2300 RC , Leiden, The Netherlands

    Rob A. E. M. Tollenaar

Authors
  1. Catherina S. P. van Rijswijk
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  2. Maartje J. A. Geirnaerdt
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  3. Pancras C. W. Hogendoorn
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  4. Johannes L. Peterse
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  5. Frits van Coevorden
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  6. Antonie H. M. Taminiau
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  9. Johan L. Bloem
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Correspondence to Catherina S. P. van Rijswijk.

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van Rijswijk, C.S.P., Geirnaerdt, M.J.A., Hogendoorn, P.C.W. et al. Dynamic contrast-enhanced MR imaging in monitoring response to isolated limb perfusion in high-grade soft tissue sarcoma: initial results. Eur Radiol 13, 1849–1858 (2003). https://doi.org/10.1007/s00330-002-1785-4

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  • DOI: https://doi.org/10.1007/s00330-002-1785-4

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