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Souza FF, D’Amato G, Jonczak EE, Costa P, Trent JC, Rosenberg AE, Yechieli R, Temple HT, Pattany P, Subhawong TK. MRI T2 mapping assessment of T2 relaxation time in desmoid tumors as a quantitative imaging biomarker of tumor response: preliminary results. Front Oncol 2023; 13:1286807. [PMID: 38188297 PMCID: PMC10766853 DOI: 10.3389/fonc.2023.1286807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/17/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives Because size-based imaging criteria poorly capture biologic response in desmoid-type fibromatosis (DF), changes in MRI T2 signal intensity are frequently used as a response surrogate, but remain qualitative. We hypothesized that absolute quantification of DF T2 relaxation time derived from parametric T2 maps would be a feasible and effective imaging biomarker of disease activity. Methods This IRB-approved retrospective study included 11 patients with DF, managed by observation or systemic therapy, assessed by 3T MRI. Tumor maximum diameter, volume, and T2-weighted signal intensity were derived from manual tumor segmentations. Tumor:muscle T2 signal ratios were recorded. Two readers measured tumor T2 relaxation times using a commercial T2 scanning sequence, manual ROI delineation and commercial calculation software enabling estimation of reader reliability. Objective response rates based on RECIST1.1 and best responses were compared between size-based and signal-based parameters. Results Median patient age was 52.6 years; 8 subjects were female (73%). Nine patients with longitudinal assessments were followed for an average of 314 days. Median baseline tumor diameter was 7.2 cm (range 4.4 - 18.2 cm). Median baseline T2 was 65.1 ms (range 40.4 - 94.8 ms, n=11); median at last follow-up was 44.3 ms (-32% from baseline; range 29.3 - 94.7 ms, n=9). T2 relaxation times correlated with tumor:muscle T2 signal ratios, Spearman p=0.78 (p<0.001). T2 mapping showed high inter-reader reliability, ICC=0.84. The best response as a percentage change in T2 values was statistically significant (mean -17.9%, p=0.05, paired t-test) while change in diameter was not (mean -8.9%, p=0.12). Conclusions Analysis of T2 relaxation time maps of DF may offer a feasible quantitative biomarker for assessing the extent of response to treatment. This approach may have high inter-reader reliability.
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Affiliation(s)
- Felipe F. Souza
- Department of Radiology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
| | - Gina D’Amato
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Internal Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Emily Elizabeth Jonczak
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Internal Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Philippos Costa
- Department of Internal Medicine, Yale Medicine, New Haven, CT, United States
| | - Jonathan C. Trent
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Internal Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Andrew E. Rosenberg
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Pathology & Laboratory Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Raphael Yechieli
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Radiation Oncology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - H. Thomas Temple
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
- Department of Orthopaedics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Pradip Pattany
- Department of Radiology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Ty K. Subhawong
- Department of Radiology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
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Triantafyllou M, Klontzas ME, Koltsakis E, Papakosta V, Spanakis K, Karantanas AH. Radiomics for the Detection of Active Sacroiliitis Using MR Imaging. Diagnostics (Basel) 2023; 13:2587. [PMID: 37568950 PMCID: PMC10416894 DOI: 10.3390/diagnostics13152587] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Detecting active inflammatory sacroiliitis at an early stage is vital for prescribing medications that can modulate disease progression and significantly delay or prevent debilitating forms of axial spondyloarthropathy. Conventional radiography and computed tomography offer limited sensitivity in detecting acute inflammatory findings as these methods primarily identify chronic structural lesions. Conversely, Magnetic Resonance Imaging (MRI) is the preferred technique for detecting bone marrow edema, although it is a complex process requiring extensive expertise. Additionally, ascertaining the origin of lesions can be challenging, even for experienced medical professionals. Machine learning (ML) has showcased its proficiency in various fields by uncovering patterns that are not easily perceived from multi-dimensional datasets derived from medical imaging. The aim of this study is to develop a radiomic signature to aid clinicians in diagnosing active sacroiliitis. A total of 354 sacroiliac joints were segmented from axial fluid-sensitive MRI images, and their radiomic features were extracted. After selecting the most informative features, a number of ML algorithms were utilized to identify the optimal method for detecting active sacroiliitis, leading to the selection of an Extreme Gradient Boosting (XGBoost) model that accomplished an Area Under the Receiver-Operating Characteristic curve (AUC-ROC) of 0.71, thus further showcasing the potential of radiomics in the field.
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Affiliation(s)
- Matthaios Triantafyllou
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71500 Heraklion, Greece
| | - Michail E. Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71500 Heraklion, Greece
| | - Emmanouil Koltsakis
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
- Department of Radiology, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Vasiliki Papakosta
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
| | - Konstantinos Spanakis
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
| | - Apostolos H. Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece; (M.T.); (M.E.K.); (E.K.); (V.P.); (K.S.)
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71500 Heraklion, Greece
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AbuMoussa S, Roshan MP, Souza FF, Daley D, Rosenberg A, Pretell J, Fullerton N, Subhawong T. Soft Tissue Masses of the Hand: A Review of Clinical Presentation and Imaging Features. Curr Oncol 2023; 30:2032-2048. [PMID: 36826119 PMCID: PMC9955517 DOI: 10.3390/curroncol30020158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 02/11/2023] Open
Abstract
More than 15% of all soft-tissue tumors arise in the hand. Because of the location of these tumors, even small abnormalities may be alarming to patients on presentation. Although the majority of lesions are benign and can be diagnosed solely by history and physical examination, additional imaging workup may be required to confirm a diagnosis or define anatomic extent of involvement. This paper aims to review the basic epidemiology, clinical presentation, imaging findings, and treatment options of the more common soft-tissue tumors of the hand.
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Affiliation(s)
- Samuel AbuMoussa
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Mona Pari Roshan
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Felipe Ferreira Souza
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Dane Daley
- Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Andrew Rosenberg
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan Pretell
- Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Natalia Fullerton
- Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ty Subhawong
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Correspondence: ; Tel.: +1-(305)-585-7500
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