Dr Matthew Blackledge
Next-generation magnetic resonance imaging (MRI) for response assessment of soft-tissue sarcoma to pre-operative radiotherapy
Approximately 3,300 cases of soft-tissue sarcoma (STS) are diagnosed in the UK every year. It is estimated that about half of these patients will live for five or more years following surgical removal of tumours. Radiotherapy, which kills tumour cells using high energy X-rays, can be used before surgery to improve the chances of successful treatment.
Conventional approaches for identifying whether a patient will respond well to radiotherapy involve taking pictures of the tumour with computed tomography (CT), or magnetic resonance imaging (MRI). The size of the tumour is then monitored to determine whether the treatment is causing tumour shrinkage. However, evidence suggests that STS tumours consist of distinct biological sub-regions that respond differently to radiotherapy (tumours are ‘heterogeneous’). This makes overall tumour size an inadequate measure of response.
The aim of this study is to develop a new imaging approach that is more accurate in assessing STS response to radiotherapy. In particular, this approach would provide a spatial map that measures how distinct biological sub-regions within STS tumours are responding differently to the same treatment. This technique will be tested in a dedicated patient study, and validated by performing advanced tissue analyses within each of the STS sub-regions detected. This would provide a much better diagnostic assessment of STS tumour response to radiotherapy, and allow treatment to be increased in the most aggressive regions. This methodology has the potential to improve patient outcome and reduce the side-effects of treatment by sparing healthy tissues from irradiation.