From the Departments of Radiology (T.K.S., N.A.), Pathology (A.R.), and Medicine-Medical Oncology (J.T., B.A.W.), Sylvester Comprehensive Cancer Center and the University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave, JMH WW 279, Miami, FL 33136; Department of Radiology, University of Miami Miller School of Medicine, Miami, Fla (K.F., K.S.); and Department of Public Health Sciences, Sylvester Biostatistics and Bioinformatics Shared Resource, University of Miami Miller School of Medicine, Miami, Fla (D.K.).
Radiol Imaging Cancer. 2021 Jul;3(4):e210016. doi: 10.1148/rycan.2021210016.
Purpose To determine whether MRI volumetric and image texture analysis correlates with treatment-induced biologic changes in desmoid fibromatosis (DF) earlier than conventional response criteria. Materials and Methods This retrospective study included 27 patients with histologically proven extra-abdominal DF who were managed with active surveillance or systemic therapy (from 2004 to 2016). MRI volumetric and image texture parameters were derived from manual tumor segmentations, and tumor signal intensity was normalized to muscle. Results were compared with objective response rates based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, World Health Organization (WHO) lesion response, volumetrics, and MRI-modified Choi criteria. Correlation coefficients () between image texture features and maximum tumor diameters were obtained by using a meta-analysis approach. Results The 27 included patients (mean age, 39 years; 74% women) were followed for an average of 4 years, comprising 207 distinct time-point assessments. The mean baseline tumor maximum diameter was 7.9 cm (range, 3.4-15.2 cm). Partial response (PR) rates as best response were 37%, 44%, 70%, and 81% by RECIST, WHO, volumetrics, and MRI-modified Choi criteria, respectively. Among the 10 tumors showing RECIST PR, a preceding MRI-modified Choi PR was observed in 70% (seven of 10), on average 1.3 years earlier. Multiple image texture parameters showed associations with objective measurements of tumor diameter including mean tumor-to-muscle signal ratio ( = 0.51; = .004), median tumor-to-muscle signal ratio ( = 0.52; = .003), energy ( = 0.48; < .001), run entropy ( = 0.32, = .04), and gray-level nonuniformity ( = 0.54; ≤ .001). Conclusion Volumetric signal and image texture assessment allows more comprehensive analysis of DF biologic change and may permit early prediction of DF behavior and therapeutic response. MR Imaging, Soft Tissues/Skin, Neoplasms-Primary © RSNA, 2021.
在常规反应标准之前，确定 MRI 容积和图像纹理分析是否与诱导性纤维瘤病 (DF) 的治疗引起的生物学变化相关。
本回顾性研究纳入了 27 例经组织学证实的腹外 DF 患者，这些患者接受了主动监测或全身治疗（2004 年至 2016 年）。从手动肿瘤分割中得出 MRI 容积和图像纹理参数，并将肿瘤信号强度归一化为肌肉。结果与实体瘤反应评估标准（RECIST）1.1、世界卫生组织（WHO）病变反应、容积和 MRI 改良 Choi 标准的客观反应率进行比较。使用荟萃分析方法获得图像纹理特征与最大肿瘤直径之间的相关系数（r）。
27 例纳入患者（平均年龄，39 岁；74%为女性）的平均随访时间为 4 年，共进行了 207 次不同时间点的评估。基线时最大肿瘤直径的平均值为 7.9 cm（范围，3.4-15.2 cm）。RECIST、WHO、容积和 MRI 改良 Choi 标准的最佳反应部分缓解（PR）率分别为 37%、44%、70%和 81%。在 10 个显示 RECIST PR 的肿瘤中，有 70%（7/10）在 MRI 改良 Choi PR 之前，平均提前 1.3 年。多个图像纹理参数与肿瘤直径的客观测量值相关，包括平均肿瘤与肌肉信号比（r = 0.51；P =.004）、中位数肿瘤与肌肉信号比（r = 0.52；P =.003）、能量（r = 0.48；P <.001）、运行熵（r = 0.32，P =.04）和灰度不均匀性（r = 0.54；P ≤.001）。
容积信号和图像纹理评估允许更全面地分析 DF 的生物学变化，并可能允许早期预测 DF 的行为和治疗反应。
磁共振成像，软组织/皮肤，肿瘤-原发性
© RSNA，2021。
