CT-response patterns and the role of CT-textural features in inoperable abdominal/retroperitoneal soft tissue sarcomas treated with trabectedin. Issue 107 (October 2018)

• Record Type: Journal Article
• Authors: Esser, Michael; Kloth, Cristopher; Thaiss, Wolfgang Maximilian; Reinert, Christian Philipp; Fritz, Jan; Kopp, Hans-Georg; Horger, Marius
• Is Part Of: European journal of radiology. Issue 107(2018)
• Page Start: 175
• Page End: 182
• Publication Date: 2018-10
• Subjects: CI ConfidenceInterval -- CT ComputedTomography -- CTTA CT-TexturalAnalysis -- DCR Disease Control Rate -- DNA DeoxyribonucleicAcid -- FDG-PET Fludeoxyglucose-Positron Emission Tomography -- Fig. Figure -- GIST Gastrointestinal Stromal Tumor -- NGLD MNeighboring Grey-Level Dependence Matrix -- PD Progressive Disease -- PR Partial Response -- RECIST Response Evaluation Criteria in Solid Tumors -- ROC Receiver Operating Characteristic -- SD Stable Disease -- STS Soft tissue sarcoma -- Tab. Table -- TTP Time to Progression -- USA United States of America -- VOI Volume of Interest; Sarcoma -- Soft tissue -- Trabectedin -- Tomography -- Spiral computed; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2018.09.006
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: A frequent pattern of response to trabectedin is tumor liquefication. ModifiedCHOI should be preferred when monitoring response under trabectedin. Texture analysis can be used for prediction and monitoring response to trabectedin. A mean of heterogeneity >0.12 in baseline predicts response with a sensitivity of 89%. Abstract: Purpose: To evaluate CT patterns and textural features of soft tissue sarcomas following trabectedin therapy as well as their suitability for predicting therapeutic response. Material and methods: A total of 31 patients (18 female, 13 male; mean age, 58.0years; range, 38–79years) with sarcoma under trabectedin as a third-line therapy between October 2008 and July 2017 underwent baseline and follow-up contrast-enhanced CT. Response evaluation was based on modifiedCHOI-criteria and RECIST1.1, classified as partial response(PR), stable disease(SD), progressive disease(PD). For CT-texture analysis (CTTA), mean, entropy and uniformity of intensity/skewness/entropy of co-occurrence matrix (COM) and contrast of neighboring-grey-level-dependence-matrix (NGLDM) were calculated. Results: Following CHOI-criteria, 9 patients achieved PR, 10 SD and 12 PD. RECIST1.1. classified patients into 5 PR, 15 SD and 11 PD. A frequent (n = 6/31; 19.3%) pattern of response was tumor liquefaction. In responders differences in entropy of entropy-NGLDM(p = 0.028) and uniformity-NGLDM(p = 0.021), in non-responders entropy of average(p = 0.039), deviation(p = 0.04) and uniformity of deviation(p = 0.013) occured between baseline and follow-up. Mean intensity and average were higher when liquefication occured(p = 0.03; p = 0.02), whereas mean deviation was lower(p = 0.02) at baseline compared to other response patterns. Differences in mean(p = 0.023), entropy(p = 0.049) and uniformity(p = 0.023) of entropy-NGLDM were found between responders and non-responders at follow-up. For the mean of heterogeneity a cut-off value was calculated for prediction of response in baseline CTTA (0.12; sensitivity 89%; specificity 77%). Conclusion: A frequent pattern of response to trabectedin was tumor liquefication being responsible for pseudoprogression, therefore modifiedCHOI should be preferred. Single CT-textural features can be used complementarily for prediction and monitoring response to trabectedin.