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The Desmoid Tumor Research Foundation

May 2020

Association of MRI T2 Signal Intensity With Desmoid Tumor Progression During Active Observation: A Retrospective Cohort Study

Author Information

Cassidy MR(1)(2), Lefkowitz RA(3), Long N(3), Qin LX(4), Kirane A(1), Sbaity E(1), Hameed M(5), Coit DG(1)(6), Brennan MF(1)(6), Singer S(1)(6), Crago AM(1)(6).

(1)Gastric and Mixed Tumor Service, Dept of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. (2)Section of Surgical Oncology, Boston University School of Medicine, Boston,MA. (3)Dept of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. (4)Dept of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. (5)Dept of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY. (6)Dept of Surgery, Weill Cornell Medical Center, New York, NY.

Publication

Ann Surg

Summary

The aim of this study was to identify predictors of desmoid progression during observation. Primary or recurrent desmoid patients were identified retrospectively from an institutional database. In those managed with active observation who underwent serial magnetic resonance imaging (MRIs) with T2-weighted sequences, baseline tumor size was recorded, and 2 radiologists independently estimated the percentage of tumor volume showing hyperintense T2 signal at baseline. Associations of clinical or radiographic characteristics with progression-free survival (PFS; by RECIST) were evaluated by Cox regression and Kaplan-Meier statistics. Although PFS was not associated with size, site, or age, it was strongly associated with hyperintense T2 signal in ≥90% versus <90% of baseline tumor volume (as defined by the "test" radiologist; hazard ratio = 11.3, P = 0.003). For patients in the ≥90% group (n = 20), 1-year PFS was 55%, compared with 94% in the <90% group (n = 17). The percent tumor volume characterized by hyperintense T2 signal is associated with desmoid progression during observation and may help distinguish patients who would benefit from early intervention from those who may be reliably observed.

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