Soft Tissue Sarcomas: The Role of Quantitative MRI in Treatment Response Evaluation

Acad Radiol. 2022 Jul;29(7):1065-1084. doi: 10.1016/j.acra.2021.08.007. Epub 2021 Sep 20.

Abstract

Background: Although curative surgery remains the cornerstone of the therapeutic strategy in patients with soft tissue sarcomas (STS), neoadjuvant radiotherapy and chemotherapy (NART and NACT, respectively) are increasingly used to improve operability, surgical margins and patient outcome. The best imaging modality for locoregional assessment of STS is MRI but these tumors are mostly evaluated in a qualitative manner.

Objective: After an overview of the current standard of care regarding treatment for patients with locally advanced STS, this review aims to summarize the principles and limitations of (i) the current methods used to evaluate response to neoadjuvant treatment in clinical practice and clinical trials in STS (RECIST 1.1 and modified Choi criteria), (ii) quantitative MRI sequences (i.e., diffusion weighted imaging and dynamic contrast enhanced MRI), and (iii) texture analyses and (delta-) radiomics.

Keywords: Magnetic resonance imaging; Quantitative imaging; Soft tissue sarcomas; Treatment response.

Publication types

  • Review

MeSH terms

  • Humans
  • Magnetic Resonance Imaging / methods
  • Neoadjuvant Therapy / methods
  • Retrospective Studies
  • Sarcoma* / drug therapy
  • Sarcoma* / therapy
  • Soft Tissue Neoplasms* / drug therapy
  • Soft Tissue Neoplasms* / therapy
  • Treatment Outcome