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Abstract #2064

Distinct Biological Response Patterns During Neoadjuvant Radiation Therapy in Soft Tissue Sarcoma: A Multiparametric MRI Clustering Analysis

Balazs Bogner1, Alexander Runkel2, Simon Reiss1, Marco Reisert1, Jakob Weiss1, Fabian Bamberg1, Thierno D. Diallo1, and Matthias Jung1
1Radiology, University Medical Center Freiburg, Freiburg, Germany, 2Plastic Surgery, University Medical Center Freiburg, Freiburg, Germany

Synopsis

Keywords: Other Musculoskeletal, biomarkers, Soft Tissue Sarcoma, DWI, IVIM, DCE

Motivation: Despite standardized neoadjuvant radiation therapy (NRT) protocols in soft tissue sarcomas (STS), treatment response varies significantly between patients, yet lacks reliable non-invasive monitoring methods during treatment.

Goal(s): To identify distinct radiation therapy response patterns using multiparametric MRI for early response monitoring.

Approach: Prospective analysis of 20 STS patients using standardized quantitative MRI protocol at three timepoints during NRT.

Results: ADC was the only parameter showing significant temporal evolution during treatment (p<0.001). Statistical clustering analysis identified three distinct, highly stable response patterns with significant inter-cluster differences in ADC (p=0.001) and Ktrans (p=0.003).

Impact: This analysis reveals distinct biological response phenotypes during radiation therapy that can be identified through non-invasive imaging. These findings could enable early response prediction and therapy adaptation, potentially improving patient outcomes through personalized treatment approaches.

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