Role of MRI diffusion in evaluation the therapeutic response and prognostic outcome in pediatric patients with Rhabdomyosarcoma

Document Type : Original Article

Authors

1 Radiodiagnosis,medicine,benha

2 Head of radiology departement , Faculty of medicine , Benha university

3 oncology,medicine,benisuef

4 diagnostic radiology,medicine,national cancer institute

Abstract

Background: Childhood rhabdomyosarcoma accounts for about 3.5% of cancer cases among children 0 to 14 years of age. The most common sites are the head and neck. Early detection of treatment response might change therapeutic strategies and unnecessary toxicity might be avoided. The differentiation between post-therapeutic changes and recurrent tumors in RMS is a diagnostic dilemma. DWI helps predict and monitor treatment response in RMS, as changes in ADC precede changes in tumor size. For the differentiation between recurrent tumor and post-therapeutic changes, qualitative and quantitative assessment using DWI seems to be helpful.
Purpose: assess the accuracy of DW-MRI in evaluation, monitoring the treatment response in RMS and differentiation between recurrent tumor and post-therapeutic changes.
Data Sources: Previous literature, reviews, and studies as well as medical websites (PubMed, radiographic and Science Direct) and scientific journals databases were searched from the start date of each database.
Patients and methods: During the period between April 2017 to April 2019, 40 pediatric patients with rhabdomyosarcoma (24 male and 16 female) were enrolled prospectively. All patients underwent standard MRI protocol and DW-MRI. PET/CT was done and correlate the SUV/MAX value with the DWI results.
Results: Correlation between DW-MRI and PET/CT showing 100 % sensitivity and 82.14 % specificity with 87.50 % accuracy in differentiation between recurrent tumor and post-therapeutic changes.
Conclusion:
The DW-MRI allows accurate characterization of rhabdomyosarcoma, assessment of treatment response, and differentiation between recurrent tumor and post-therapeutic changes.
Keywords: DW-MRI, pediatric, rhabdomyosarcoma.

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