Imaging response evaluation after neoadjuvant treatment in soft tissue sarcomas: Where do we stand?

Nicolo Gennaro*, Sophie Reijers, Annemarie Bruining, Christina Messiou, Rick Haas, Piergiuseppe Colombo, Zuhir Bodalal, Regina Beets-Tan, Winan van Houdt, Winette T. A. van der Graaf

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

8 Citations (Web of Science)

Abstract

Soft tissue sarcomas (STS) represent a broad family of rare tumours for which surgery with radiotherapy represents first-line treatment. Recently, neoadjuvant chemo-radiotherapy has been increasingly used in high-risk patients in an effort to reduce surgical morbidity and improve clinical outcomes. An adequate understanding of the efficacy of neoadjuvant therapies would optimise patient care, allowing a tailored approach. Although response evaluation criteria in solid tumours (RECIST) is the most common imaging method to assess tumour response, Choi criteria and functional and molecular imaging (DWI, DCE-MRI and 18F-FDG-PET) seem to outperform it in the discrimination between responders and non-responders. Moreover, the radiologic-pathology correlation of treatment-related changes remains poorly understood. In this review, we provide an overview of the imaging assessment of tumour response in STS undergoing neoadjuvant treatment, including conventional imaging (CT, MRI, PET) and advanced imaging analysis. Future directions will be presented to shed light on potential advances in pre-surgical imaging assessments that have clinical implications for sarcoma patients.

Original languageEnglish
Article number103309
Number of pages11
JournalCritical Reviews in Oncology/Hematology
Volume160
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Sarcoma
  • Pathology
  • Imaging
  • Tumour response evaluation
  • CT, MRI, PET/CT
  • INDUCED PATHOLOGICAL NECROSIS
  • ENHANCED COMPUTED-TOMOGRAPHY
  • HIGH-RISK EXTREMITY
  • PHASE-I TRIAL
  • PREOPERATIVE RADIOTHERAPY
  • EUROPEAN ORGANIZATION
  • HISTOPATHOLOGIC RESPONSE
  • TEXTURE ANALYSIS
  • TUMOR RESPONSE
  • EVALUATION CRITERIA

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