Page 48 - TD-2-3

Tumor Discovery

ORIGINAL RESEARCH ARTICLE
Early results in the novel use of contrast-enhanced

susceptibility-weighted imaging in the assessment
of response and progression in desmoid

fibromatosis: A pilot study in a specialized cancer
institution

†
†
Raul F. Valenzuela *, Elvis Duran Sierra , Mathew A. Canjirathinkal,
Colleen M. Costelloe, John E. Madewell, William A. Murphy Jr., and
Behrang Amini
Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center,
Houston, Texas 77030, USA

Abstract

Routine radiologic reporting (RRR) often considers progressive desmoid tumors
to have a higher proportion of T2-hyperintense and T1-shortened-enhancing
† These authors contributed equally components, while responsive or mature collagenized tumors demonstrate a higher
to this work.
proportion of T2-hypointense-non-enhancing components. We aim to determine
*Corresponding author: the utility of the novel use of contrast-enhanced susceptibility-weighted imaging
Raul F. Valenzuela
(rfvalenzuela@mdanderson.org) (CE-SWI) in Desmoid-Tumor treatment response assessment, distinguishing between
the T1-shortening-enhancing/T2-hyperintense immature components from the
Citation: Valenzuela RF, Sierra ED, T2-hypointense mature collagenized components. This pilot study included 10
Canjirathinkal MA, et al., 2023,
Early results in the novel use of single-lesion extremity desmoid fibromatosis patients undergoing standard-of-
contrast-enhanced susceptibility- care magnetic resonance imaging, including CE-SWI. Three-dimensional (3D) tumor
weighted imaging in the assessment segmentation was performed using MIM software in 48 volumes of interest. Maximum
of response and progression in
desmoid fibromatosis: A pilot study diameter, volume, and modified Choi (mChoi) measurements were computed from
in a specialized cancer institution. CE-SWI and T2-weighted image (T2-WI). Five first-order radiomic features, including
Tumor Discov, 2(3): 1414. mean, skewness, kurtosis, and 10 and 90 percentiles, were calculated using
th
th
https://doi.org/10.36922/td.1414
in-house developed software (CARPI-AF). (i) RECIST Progression: We observed two
Received: July 30, 2023 cases of progression according to the T2-WI-based Response Evaluation Criteria in
Accepted: October 10, 2023 Solid Tumors standard (RECIST). Interestingly, CE-SWI-based-volume and CE-SWI-
based-mChoi predicted the same assessment 4.5 months earlier than T2-WI-based-
Published Online: November 6,
2023 RECIST. RRR assessed both cases as progression; (ii) RECIST Stability: Out of the eight
patients classified as having stable disease by T2-WI-based-RECIST, four discrepant
Copyright: © 2023 Author(s).
This is an Open Access article progressions were determined: three patients showed an increase greater than 25%
distributed under the terms of the of T2-WI-based-volume, and two patients showed an increase greater than 25% of
Creative Commons Attribution CE-SWI-based-volume. Moreover, from the RECIST stable group, four discrepant-
License, permitting distribution,
and reproduction in any medium, positive responses were predicted by CE-SWI-based-mChoi (three patients) and T2-WI-
provided the original work is based-mChoi (four patients). RRR only assessed one patient as having progressive
properly cited. disease; (iii) First-Order Radiomics: CE-SWI detected 23% more 90th-percentile
Publisher’s Note: AccScience voxels than T2-WI, while T2-WI demonstrated 8.5% more 10th-percentile voxels
Publishing remains neutral with than CE-SWI. Notably, expected first-order response/progression-related changes in
regard to jurisdictional claims in
published maps and institutional 10th-percentile, 90th-percentile, mean, and skewness were present in 90% of cases.
affiliations. In conclusion, CE-SWI-based-volume and CE-SWI-based-mChoi measurements could

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/td.1414