Publications [#168978] of Mark W. Dewhirst

Papers Published

1. BL Viglianti, M Lora-Michiels, JM Poulson, L Lan, D Yu, D Yu, L Sanders, O Craciunescu, Z Vujaskovic, DE Thrall, J Macfall, CH Charles, T Wong, MW Dewhirst, Dynamic contrast-enhanced magnetic resonance imaging as a predictor of clinical outcome in canine spontaneous soft tissue sarcomas treated with thermoradiotherapy., Clinical cancer research : an official journal of the American Association for Cancer Research, vol. 15 no. 15 (August, 2009), pp. 4993-5001, ISSN 1078-0432 [doi]
   (last updated on 2013/05/13)

   Abstract:
   OBJECTIVE: This study tests whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters obtained from canine patients with soft tissue sarcomas, treated with hyperthermia and radiotherapy, are predictive of therapeutic outcome. METHODS: Thirty-seven dogs with soft tissue sarcomas had DCE-MRI done before and following the first hyperthermia. Signal enhancement for tumor and reference muscle were fitted empirically, yielding a washin/washout rate for the contrast agent and tumor area under the signal enhancement curve (AUC) calculated from 0 to 60 seconds, 90 seconds, and the time of maximal enhancement in the reference muscle. These parameters were then compared with local tumor control, metastasis-free survival, and overall survival. RESULTS: Pretherapy rate of contrast agent washout was positively predictive of improved overall and metastasis-free survival with hazard ratio of 0.67 (P = 0.015) and 0.68 (P = 0.012), respectively. After the first hyperthermia washin rate, AUC60, AUC90, and AUCt-max were predictive of improved overall and metastasis-free survival with hazard ratio ranging from 0.46 to 0.53 (P < 0.002) and 0.44 to 0.55 (P < 0.004), respectively. DCE-MRI parameters were compared with extracellular pH and (31)P MR spectroscopy results (previously published) in the same patients showing a correlation. This suggested that an increase in perfusion after therapy was effective in eliminating excess acid from the tumor. CONCLUSIONS: This study shows that DCE-MRI has utility predicting overall and metastasis-free survival in canine patients with soft tissue sarcomas. To our knowledge, this is the first time that DCE-MRI parameters are predictive of clinical outcome for soft tissue sarcomas.

   Keywords:
   Animals • Combined Modality Therapy • Dog Diseases • Dogs • Hyperthermia, Induced • Image Enhancement • Kaplan-Meier Estimate • Magnetic Resonance Imaging • Prognosis • Radiotherapy • Radiotherapy Dosage • Sarcoma • Soft Tissue Neoplasms • Treatment Outcome • diagnosis • diagnosis* • methods • pathology • veterinary • veterinary*