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The effect of radiotherapy on fat content and fatty acids in myxoid liposarcomas quantified by MRI
Umeå University, Faculty of Medicine, Department of Radiation Sciences. Department of Radiology, Uppsala, Sweden.
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2017 (English)In: Magnetic Resonance Imaging, ISSN 0730-725X, E-ISSN 1873-5894, Vol. 43, p. 37-41Article in journal (Refereed) Published
Abstract [en]

Background: Myxoid liposarcomas are highly radiosensitive. Consequently radiotherapy is often used pre-operatively to reduce tumor volume and lessen the post-operative deficit. In soft-tissue sarcomas therapy response is mainly evaluated using magnetic resonance imaging (MRI) and the fundamental criterion for a positive response is decreased tumor size. In myxoid liposarcomas an increased fat content is also known to occur as a response to radiotherapy. Objective: To highlight the difficulties of MRI for therapy response evaluation in irradiated myxoid liposarcomas, by using MRI Dixon techniques enabling objective quantification of proton density fat fraction (%) and the number of double bonds (ndb; unsaturation degree) of fatty acids. Secondly, to compare quantitative fat fraction measurements versus visual grading of fat content on T1-weighted images. Case descriptions: Prior to surgery, two patients with myxoid liposarcoma were treated with 50 Gy. Following radiotherapy, both tumors on MRI showed reduced size, elevated fat fraction and transformed fat fraction histograms with diverse changes of ndb, while histopathological specimens showed discordant treatment effects; one case having good response and the other having poor response. Conclusions: A decrease in tumor size and increase in fat content on MRI cannot be interpreted as positive therapy response in radiotherapy of myxoid liposarcomas. Our data also give further supporting evidence that differentiation and maturation of tumor cells is the cause for the lipoma-like areas seen after radiotherapy. Finally, quantitative MRI Dixon techniques are preferable to visual grading for estimating the fat content in lipomatous tumors.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 43, p. 37-41
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Radiology, Nuclear Medicine and Medical Imaging
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URN: urn:nbn:se:umu:diva-141798DOI: 10.1016/j.mri.2017.07.005ISI: 000413611600005PubMedID: 28698004OAI: oai:DiVA.org:umu-141798DiVA, id: diva2:1161306
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-06-09Bibliographically approved

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Skorpil, Mikael

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