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Monitoring the effect of chemotherapy in Ewing's sarcoma of bone with MR imaging

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Abstract

Magnetic resonance (MR) imaging was performed in 26 patients with Ewing's sarcoma of bone preceding and following neoadjuvant chemotherapy, to assess tumour response non-invasively prior to surgery. T1- and T2-weighted spin echo images were obtained. Changes including intra- and extramedullary signal intensities, tumour demarcation, tumour volume and the appearance of residual extramedullary tumour were compared with histopathology of the resected specimens. Reduction of tumour volume was significantly higher in good responders. Other single parameters did not correlate with histologic tumour response. However, when several MR parameters summarized in a classification system were combined, a positive correlation with histopathologic response was found. A limited decrease of tumour volume (<25%) and/or residual soft tissue mass following chemotherapy correlated with a poor response. An inhomogeneous, well-defined cuff of abnormal tissue encircling the bone and/or radiological disappearance of the soft tissue tumour component following chemotherapy correlated with good response. Twenty-three out of 26 patients were correctly classified by MR as good or poor responders. Minimal residual disease (<10% of the entire tumour volume), observed histologically, could not be identified with MR imaging. Tumour volume reduction and residual extramedullary tumour, rather than changes of signal intensity, are major features for evaluating the response to chemotherapy in Ewing's sarcoma.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, University Hospital, Leiden, The Netherlands

    H. J. van der Woude M.D., J. L. Bloem M.D. & H. C. Holscher M.D.

  2. Department of Clinical Oncology, University Hospital, Leiden, The Netherlands

    M. A. Nooy M.D.

  3. Department of Orthopedic Surgery, University Hospital, Leiden, The Netherlands

    A. H. M. Taminiau M.D.

  4. Department of Medical Statistics, University Hospital, Leiden, The Netherlands

    J. Hermans Ph.D.

  5. Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands

    T. H. M. Falke M.D.

  6. Department of Pathology, University Hospital, Leiden, The Netherlands

    H. J. van der Woude M.D. & P. C. W. Hogendoorn M.D.

Authors
  1. H. J. van der Woude M.D.
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  2. J. L. Bloem M.D.
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  3. H. C. Holscher M.D.
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  4. M. A. Nooy M.D.
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  5. A. H. M. Taminiau M.D.
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  6. J. Hermans Ph.D.
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  7. T. H. M. Falke M.D.
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  8. P. C. W. Hogendoorn M.D.
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van der Woude, H.J., Bloem, J.L., Holscher, H.C. et al. Monitoring the effect of chemotherapy in Ewing's sarcoma of bone with MR imaging. Skeletal Radiol. 23, 493–500 (1994). https://doi.org/10.1007/BF00223076

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