Background: Dynamic contrast-enhanced MR imaging (DCE-MR) is becoming\na widely accepted complementary method for diagnosing breast cancer\nand other cancers in adults. It is useful to predict tumor response to anticancer\ntherapy and monitor the tumor response to the therapy. This form of\nimaging techniques has not been adequately explored in pediatric oncology\npatients. Objective: To determine the potential role of dynamic contrastenhanced\nMR imaging (DCE-MR) in the diagnosis and treatment response\nmonitoring of childhood and young adult extra-cranial tumors in routine\nclinical setting. Methods: Children with suspected extra-cranial solid tumors,\nincluding newly diagnosed or follow-up cases of confirmed tumors, were recruited.\nDCE-MR was performed with intravenous injection of 0.1 mmol/kg\ncontrast. The enhancement time curves were plotted and the enhancement\npatterns were categorized into type 1, 2 and 3 curves. Enhancement curve\npatterns and maximal enhancement intensity were compared with types of\ntumor in newly diagnosed cases. The preoperative percentiles of inactive area\non the colour map were compared with the necrotic areas on histologic sections\nof the resected specimens in follow-up cases. Pearson Chi-square test\nand Unpaired two-sample t-test were used for statistical analysis. Results:\nThere were 36 patients, involving 28 malignant and 8 benign cases. There\nwere 14 type 3 curves, (all of them were malignant tumors), 6 type 2 curves\nand 16 type 1 curves. All the benign cases (n = 8) demonstrated type 1 curve\n(accuracy & negative predictive value = 100%). All the malignant cases after\ntreatment showed type 2 or 1 curve. For those cases with operation done afterwards,\nthe extent of tumor necrosis was correlated closely with pathology\nfindings (accuracy = 93.3%). Conclusion: Type 1 curve was a good predictor\nof benign lesion. DEC-MR may have a role to play in the monitoring of the\nprogress of treatment and extent of tumor necrosis
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