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Objective <p>To evaluate multiparametric MRI features of pediatric soft-tissue sarcomas, comparing pre-treatment and post-treatment features, and assessing correlation with clinical outcomes.</p> Materials and methods <p>Retrospective cohort study, including pediatric patients (≤ 18&#xa0;years) with histologically-confirmed soft-tissue sarcomas who underwent MRI with anatomic and functional sequences in consecutive series. Post-treatment MRI was available for a subset, and features were recorded by two readers. Pre-treatment and post-treatment features were compared using Wilcoxon signed-rank test with Hodges-Lehmann estimator. Inter-reader agreement was assessed with intraclass correlation coefficient, and Mann–Whitney and Cox regression tests were used to correlate the features with clinical outcome.</p> Results <p>There were 27 patients. Pre-treatment we measured tumor size, ADCminimum (mean: 507 × 10-6mm<sup>2</sup>/s) and ADCaverage (mean: 690 × 10-6mm<sup>2</sup>/s). Post-treatment (10 patients) included a reduction in tumor size (<i>p</i> = 0.002) and higher ADCminimum (mean: 1116 × 10-6mm<sup>2</sup>/s) and ADCaverage (mean: 1344 × 10-6mm<sup>2</sup>/s) values. Pre-treatment size was larger in patients with metastasis at baseline (<i>p</i> = 0.004) and progression (<i>p</i> = 0.002), but size change after treatment did not correlate with progression. Baseline ADC​​ did not correlate with progression, but the group with progression showed less difference between pre- and post-treatment ADCminimum (<i>p</i> = 0.019) and ADCaverage (<i>p</i> = 0.032). There was excellent agreement between the readers measuring ADCminimum (ICC = 0.991) and ADCaverage (ICC = 0.978).</p> Conclusion <p>For high-grade pediatric soft-tissue sarcomas, the pre-treatment size is an important prognostic factor, and a reduction in tumor size was observed after treatment, but did not correlate with progression. However, changes to ADC values between pre-treatment and post-treatment MRI correlated with disease progression, suggesting that ADC is a potentially useful biomarker of clinical outcome.</p>

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Multiparametric assessment of high-grade pediatric soft-tissue sarcomas with anatomic and functional MRI sequences: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年9月8日

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  • Paulo de Tarso Kawakami Perez,
  • Laura Marie Fayad,
  • Mariana Batista Rosa Pinto,
  • Henrique Manoel Lederman,
  • Eliana Maria Monteiro Caran,
  • Carla Renata Pacheco Donato Macedo,
  • Julio Brandão Guimarães

摘要

Objective

To evaluate multiparametric MRI features of pediatric soft-tissue sarcomas, comparing pre-treatment and post-treatment features, and assessing correlation with clinical outcomes.

Materials and methods

Retrospective cohort study, including pediatric patients (≤ 18 years) with histologically-confirmed soft-tissue sarcomas who underwent MRI with anatomic and functional sequences in consecutive series. Post-treatment MRI was available for a subset, and features were recorded by two readers. Pre-treatment and post-treatment features were compared using Wilcoxon signed-rank test with Hodges-Lehmann estimator. Inter-reader agreement was assessed with intraclass correlation coefficient, and Mann–Whitney and Cox regression tests were used to correlate the features with clinical outcome.

Results

There were 27 patients. Pre-treatment we measured tumor size, ADCminimum (mean: 507 × 10-6mm2/s) and ADCaverage (mean: 690 × 10-6mm2/s). Post-treatment (10 patients) included a reduction in tumor size (p = 0.002) and higher ADCminimum (mean: 1116 × 10-6mm2/s) and ADCaverage (mean: 1344 × 10-6mm2/s) values. Pre-treatment size was larger in patients with metastasis at baseline (p = 0.004) and progression (p = 0.002), but size change after treatment did not correlate with progression. Baseline ADC​​ did not correlate with progression, but the group with progression showed less difference between pre- and post-treatment ADCminimum (p = 0.019) and ADCaverage (p = 0.032). There was excellent agreement between the readers measuring ADCminimum (ICC = 0.991) and ADCaverage (ICC = 0.978).

Conclusion

For high-grade pediatric soft-tissue sarcomas, the pre-treatment size is an important prognostic factor, and a reduction in tumor size was observed after treatment, but did not correlate with progression. However, changes to ADC values between pre-treatment and post-treatment MRI correlated with disease progression, suggesting that ADC is a potentially useful biomarker of clinical outcome.