Desmoid fibromatosis: MRI features of response to systemic therapy

Pooja J. Sheth, Spencer Del Moral, Breelyn A Wilky, Jonathan Trent, Jonathan Cohen, Andrew Rosenberg, H. Thomas Temple, Ty Subhawong

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: Imaging criteria for measuring the response of desmoid fibromatosis to systemic therapy are not well established. We evaluated a series of patients with desmoids who underwent systemic therapy to document magnetic resonance imaging (MRI) features associated with a positive clinical response. Materials and methods: This Institutional Review Board-approved retrospective study included 23 patients (mean age 40.5) with 29 extra-abdominal tumors. Therapeutic regimens included cytotoxic chemotherapy (n = 19), targeted therapy (n = 3), and nonsteroid anti-inflammatory drugs (NSAIDS; n = 1). Clinical effects were categorized as progressive disease, stable, or partial response. Maximum tumor dimension (Dmax), approximate tumor volume (VTumor), and quantitative tumor T2 hyperintensity and contrast enhancement (relative to muscle) for pre- and post-treatment MRIs were compared. Results: Three lesions progressed, 5 lesions were stable, whereas 21 showed a clinical response. Dmax decreased more in responders (mean −11.0 %) than in stable/progressive lesions (mean −3.6 and 0 % respectively, p = 0.28, ANOVA); by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) 27 out of 29 lesions were “stable,” including the 3 progressive lesions. In responders, VTumor change averaged −29.4 %, but −19.2 % and +32.5 % in stable and progressive lesions respectively (p = 0.002, ANOVA); by 3D criteria 14 out of 29 lesions showed a partial response. T2 hyperintensity decreased by 50–54 % in partial response/stable disease, but only by 10 % in progressive lesions (p = 0.049, t test). Changes in contrast enhancement ranged from −23 % to 0 %, but were not statistically significant among response groups (p = 0.37). Change in T2 hyperintensity showed a positive correlation with volumetric change (r = 0.40). Conclusion: Decreases in volume and T2 hyperintensity reflect the positive response of desmoid fibromatosis to systemic therapy; RECIST 1.1 criteria are not sensitive to clinically determined tumor response.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Aug 9 2016

Fingerprint

Aggressive Fibromatosis
Fibroma
Magnetic Resonance Imaging
Therapeutics
Neoplasms
Analysis of Variance
Research Ethics Committees
Tumor Burden
Anti-Inflammatory Agents
Retrospective Studies
Drug Therapy
Muscles
Pharmaceutical Preparations

Keywords

  • 3D
  • Desmoid fibromatosis
  • Extra-abdominal
  • MRI
  • Response criteria
  • Systemic therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Desmoid fibromatosis : MRI features of response to systemic therapy. / Sheth, Pooja J.; Del Moral, Spencer; Wilky, Breelyn A; Trent, Jonathan; Cohen, Jonathan; Rosenberg, Andrew; Thomas Temple, H.; Subhawong, Ty.

In: Skeletal Radiology, 09.08.2016, p. 1-9.

Research output: Contribution to journalArticle

Sheth, Pooja J. ; Del Moral, Spencer ; Wilky, Breelyn A ; Trent, Jonathan ; Cohen, Jonathan ; Rosenberg, Andrew ; Thomas Temple, H. ; Subhawong, Ty. / Desmoid fibromatosis : MRI features of response to systemic therapy. In: Skeletal Radiology. 2016 ; pp. 1-9.
@article{3e797dcd5ed84d889ca9217896fad2a5,
title = "Desmoid fibromatosis: MRI features of response to systemic therapy",
abstract = "Objective: Imaging criteria for measuring the response of desmoid fibromatosis to systemic therapy are not well established. We evaluated a series of patients with desmoids who underwent systemic therapy to document magnetic resonance imaging (MRI) features associated with a positive clinical response. Materials and methods: This Institutional Review Board-approved retrospective study included 23 patients (mean age 40.5) with 29 extra-abdominal tumors. Therapeutic regimens included cytotoxic chemotherapy (n = 19), targeted therapy (n = 3), and nonsteroid anti-inflammatory drugs (NSAIDS; n = 1). Clinical effects were categorized as progressive disease, stable, or partial response. Maximum tumor dimension (Dmax), approximate tumor volume (VTumor), and quantitative tumor T2 hyperintensity and contrast enhancement (relative to muscle) for pre- and post-treatment MRIs were compared. Results: Three lesions progressed, 5 lesions were stable, whereas 21 showed a clinical response. Dmax decreased more in responders (mean −11.0 {\%}) than in stable/progressive lesions (mean −3.6 and 0 {\%} respectively, p = 0.28, ANOVA); by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) 27 out of 29 lesions were “stable,” including the 3 progressive lesions. In responders, VTumor change averaged −29.4 {\%}, but −19.2 {\%} and +32.5 {\%} in stable and progressive lesions respectively (p = 0.002, ANOVA); by 3D criteria 14 out of 29 lesions showed a partial response. T2 hyperintensity decreased by 50–54 {\%} in partial response/stable disease, but only by 10 {\%} in progressive lesions (p = 0.049, t test). Changes in contrast enhancement ranged from −23 {\%} to 0 {\%}, but were not statistically significant among response groups (p = 0.37). Change in T2 hyperintensity showed a positive correlation with volumetric change (r = 0.40). Conclusion: Decreases in volume and T2 hyperintensity reflect the positive response of desmoid fibromatosis to systemic therapy; RECIST 1.1 criteria are not sensitive to clinically determined tumor response.",
keywords = "3D, Desmoid fibromatosis, Extra-abdominal, MRI, Response criteria, Systemic therapy",
author = "Sheth, {Pooja J.} and {Del Moral}, Spencer and Wilky, {Breelyn A} and Jonathan Trent and Jonathan Cohen and Andrew Rosenberg and {Thomas Temple}, H. and Ty Subhawong",
year = "2016",
month = "8",
day = "9",
doi = "10.1007/s00256-016-2439-y",
language = "English (US)",
pages = "1--9",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Desmoid fibromatosis

T2 - MRI features of response to systemic therapy

AU - Sheth, Pooja J.

AU - Del Moral, Spencer

AU - Wilky, Breelyn A

AU - Trent, Jonathan

AU - Cohen, Jonathan

AU - Rosenberg, Andrew

AU - Thomas Temple, H.

AU - Subhawong, Ty

PY - 2016/8/9

Y1 - 2016/8/9

N2 - Objective: Imaging criteria for measuring the response of desmoid fibromatosis to systemic therapy are not well established. We evaluated a series of patients with desmoids who underwent systemic therapy to document magnetic resonance imaging (MRI) features associated with a positive clinical response. Materials and methods: This Institutional Review Board-approved retrospective study included 23 patients (mean age 40.5) with 29 extra-abdominal tumors. Therapeutic regimens included cytotoxic chemotherapy (n = 19), targeted therapy (n = 3), and nonsteroid anti-inflammatory drugs (NSAIDS; n = 1). Clinical effects were categorized as progressive disease, stable, or partial response. Maximum tumor dimension (Dmax), approximate tumor volume (VTumor), and quantitative tumor T2 hyperintensity and contrast enhancement (relative to muscle) for pre- and post-treatment MRIs were compared. Results: Three lesions progressed, 5 lesions were stable, whereas 21 showed a clinical response. Dmax decreased more in responders (mean −11.0 %) than in stable/progressive lesions (mean −3.6 and 0 % respectively, p = 0.28, ANOVA); by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) 27 out of 29 lesions were “stable,” including the 3 progressive lesions. In responders, VTumor change averaged −29.4 %, but −19.2 % and +32.5 % in stable and progressive lesions respectively (p = 0.002, ANOVA); by 3D criteria 14 out of 29 lesions showed a partial response. T2 hyperintensity decreased by 50–54 % in partial response/stable disease, but only by 10 % in progressive lesions (p = 0.049, t test). Changes in contrast enhancement ranged from −23 % to 0 %, but were not statistically significant among response groups (p = 0.37). Change in T2 hyperintensity showed a positive correlation with volumetric change (r = 0.40). Conclusion: Decreases in volume and T2 hyperintensity reflect the positive response of desmoid fibromatosis to systemic therapy; RECIST 1.1 criteria are not sensitive to clinically determined tumor response.

AB - Objective: Imaging criteria for measuring the response of desmoid fibromatosis to systemic therapy are not well established. We evaluated a series of patients with desmoids who underwent systemic therapy to document magnetic resonance imaging (MRI) features associated with a positive clinical response. Materials and methods: This Institutional Review Board-approved retrospective study included 23 patients (mean age 40.5) with 29 extra-abdominal tumors. Therapeutic regimens included cytotoxic chemotherapy (n = 19), targeted therapy (n = 3), and nonsteroid anti-inflammatory drugs (NSAIDS; n = 1). Clinical effects were categorized as progressive disease, stable, or partial response. Maximum tumor dimension (Dmax), approximate tumor volume (VTumor), and quantitative tumor T2 hyperintensity and contrast enhancement (relative to muscle) for pre- and post-treatment MRIs were compared. Results: Three lesions progressed, 5 lesions were stable, whereas 21 showed a clinical response. Dmax decreased more in responders (mean −11.0 %) than in stable/progressive lesions (mean −3.6 and 0 % respectively, p = 0.28, ANOVA); by Response Evaluation Criteria in Solid Tumors (RECIST 1.1) 27 out of 29 lesions were “stable,” including the 3 progressive lesions. In responders, VTumor change averaged −29.4 %, but −19.2 % and +32.5 % in stable and progressive lesions respectively (p = 0.002, ANOVA); by 3D criteria 14 out of 29 lesions showed a partial response. T2 hyperintensity decreased by 50–54 % in partial response/stable disease, but only by 10 % in progressive lesions (p = 0.049, t test). Changes in contrast enhancement ranged from −23 % to 0 %, but were not statistically significant among response groups (p = 0.37). Change in T2 hyperintensity showed a positive correlation with volumetric change (r = 0.40). Conclusion: Decreases in volume and T2 hyperintensity reflect the positive response of desmoid fibromatosis to systemic therapy; RECIST 1.1 criteria are not sensitive to clinically determined tumor response.

KW - 3D

KW - Desmoid fibromatosis

KW - Extra-abdominal

KW - MRI

KW - Response criteria

KW - Systemic therapy

UR - http://www.scopus.com/inward/record.url?scp=84981163099&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84981163099&partnerID=8YFLogxK

U2 - 10.1007/s00256-016-2439-y

DO - 10.1007/s00256-016-2439-y

M3 - Article

C2 - 27502790

AN - SCOPUS:84981163099

SP - 1

EP - 9

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

ER -