Juan C Camacho1, Courtney Moreno1, Peter Harri1, and Pardeep Mittal1
1Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
Synopsis
MR plays a key role in patients with abdominal
visceral malignancies, regarding management, assessing therapy response and
surveillance
Standardized follow-up criteria and
imaging techniques should be applied to patients with abdominal malignancies,
taking into account the primary neoplasm and current therapeutic strategies
Adequate knowledge of response evaluation criteria for malignancies including WHO, EASL, RECIST
and mRECIST criteria is crucial for adequate patient surveillance.Learning Goals:
1.Describe follow up
and response evaluation criteria for malignancies including WHO, EASL, RECIST
and mRECIST criteria with additional inclusion of DWI imaging findings.
2. Review imaging role
and guidelines for follow up of patients with malignancies
3. Discuss the
importance of adequate imaging assessment after IO therapy.
4. Discuss a practical approach for response evaluation of solid
malignancies after IO therapy, recognizing common features after loco regional
treatments and recurrence patterns.
Background Information and Content:
1. Basics principles and
follow-up criteria following interventional oncology (IO) therapies
2. Imaging Role: Review of
MR imaging findings and algorithms for adequate malignancy follow up after IO
therapies.
3. Role of MR: when,
what and which sequences are useful and how to interpret findings according to
the delivered treatment
4. Definition of
response according to specific criteria following treatment (Case based
presentation).
5.Multiple interventional therapies exist for treatment of RCC, HCC, and hepatic metastases including RFA, cryotherapy, Y90 embolization, TACE, DEB-TACE
6.Interventional therapies often are associated with necrosis so that and increase in DWI signal and in ADC values may help in evaluation of tumor response prior to anatomic changes
7.Criteria which take tumor necrosis versus viable, enhancing tumor into account are better predictors of both response and survival in tumors treated with locoregional therapy: PERCIST, mRECIST, and EASL
Conclusions:
1.
MR plays a
key role in patients with abdominal visceral malignancies, regarding
management, assessing therapy response and surveillance
2.Standardized
follow-up criteria and imaging techniques should be applied to patients with abdominal
visceral malignancies, taking into account the primary neoplasm and current
therapeutic strategies
3.Adequate
knowledge of follow-up criteria and its systematic use is crucial for adequate
patient surveillance.
Acknowledgements
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