title: Follow-up of Wilms' tumour during pre-operative chemotherapy by qualitative and quantitative sonography.
abstract: OBJECTIVE
  Evaluation of textural changes in Wilms' tumour during chemotherapy by qualitative and quantitative ultrasonography.
  
  
  METHODS
  Sonograms of Wilms' tumours during chemotherapy were retrospectively evaluated (N=33) and compared with histopathology. Textural changes were prospectively quantified (N=6) by mean echogenicity (MEAN) and coefficient of variation (CV) of grey levels.
  
  
  RESULTS
  Interobserver agreement for volume measurements was strong and for follow-up of sonolucencies moderate. Chemotherapy caused significant volume reduction and two major patterns of change in sonolucencies were observed; either increase or no change. No relationship between sonolucencies and volume changes was present. Sonolucencies yielded an underestimation of necrosis (P<0.001). Trends in MEAN and CV differed between patients.
  
  
  CONCLUSIONS
  Volume was the most objective sonographic tumour response parameter. Changes in sonolucencies may provide additional information on tumour response. However, sonolucencies are not an accurate measure of total tumour necrosis. It was not possible to differentiate Wilms' tumour chemotherapy responders from non-responders by MEAN and CV.
authors.affiliation: Department of Paediatrics, University Hospital Nijmegen, P.O. Box 9101, NL-6500 HB Nijmegen, The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: Engelbrecht
authors.forename: C
authors.initials: C
authors.lastname: Hitge-Boetes
authors.forename: J
authors.initials: J
authors.lastname: Coolen
authors.forename: J M
authors.initials: JM
authors.lastname: Thijssen
authors.forename: A C
authors.initials: AC
authors.lastname: Makkus
authors.forename: J
authors.initials: J
authors.lastname: Bökkerink
authors.forename: J O
authors.initials: JO
authors.lastname: Barentsz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D012189:Retrospective Studies; D014463:Ultrasonography; D009396:Wilms Tumor / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology