Diffusion-weighted echo-planar magnetic resonance imaging for the assessment of tumor cellularity in patients with soft-tissue sarcomas.
OBJECTIVE
To investigate the eligibility of diffusion-weighted imaging (DWI) for the evaluation of tumor cellularity in patients with soft-tissue sarcomas.


METHODS
Thirty consecutive patients with a total of 31 histologically-proven soft-tissue sarcomas prospectively underwent magnetic resonance imaging (MRI) including DWI with echo-planar imaging (EPI) technique immediately before open biopsy (N = 1) or tumor resection (N = 30). Fourteen patients had no previous anticancer treatment, 16 had received neoadjuvant therapy. Tumor cellularity as determined from histological sections was compared with minimum apparent diffusion coefficient (ADC).


RESULTS
Tumor cellularity correlated well with minimum ADC in a linear fashion, with a Pearson correlation coefficient of -0.88 (95% confidence interval [CI]: -0.75 to -0.96). This relationship was not influenced by prior anticancer treatment. There was only a tendency toward lower ADC in tumor with higher grading but no significant dependency (P = 0.08).


CONCLUSIONS
DWI has proven useful for the assessment of tumor cellularity in soft-tissue sarcomas. In result, DWI may be used as a powerful noninvasive tool to monitor responses of cytotoxic treatment as reflected by changes in tumor cellularity.
Schnapauff
Dirk
D
Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany. dirk.schnapauff@charite.de
Zeile
Martin
M
Niederhagen
Manuel Ben
MB
Fleige
Barbara
B
Tunn
Per-Ulf
PU
Hamm
Bernd
B
Dudeck
Oliver
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012509:Sarcoma / Q000473:pathology* / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000628:therapy
D003287:Contrast Media; D019786:Gadolinium DTPA