The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response

Desmoid tumors are rare, locally invasive soft-tissue tumors with unpredictable clinical behavior. Imaging plays a crucial role in their diagnosis, measurement of disease burden, and assessment of treatment response. However, desmoid tumors’ unique imaging features present challenges to conventional...

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Main Authors: Yu-Cherng Chang, Bryan Nixon, Felipe Souza, Fabiano Nassar Cardoso, Etan Dayan, Erik J. Geiger, Andrew Rosenberg, Gina D’Amato, Ty Subhawong
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/5/288
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author Yu-Cherng Chang
Bryan Nixon
Felipe Souza
Fabiano Nassar Cardoso
Etan Dayan
Erik J. Geiger
Andrew Rosenberg
Gina D’Amato
Ty Subhawong
author_facet Yu-Cherng Chang
Bryan Nixon
Felipe Souza
Fabiano Nassar Cardoso
Etan Dayan
Erik J. Geiger
Andrew Rosenberg
Gina D’Amato
Ty Subhawong
author_sort Yu-Cherng Chang
collection DOAJ
description Desmoid tumors are rare, locally invasive soft-tissue tumors with unpredictable clinical behavior. Imaging plays a crucial role in their diagnosis, measurement of disease burden, and assessment of treatment response. However, desmoid tumors’ unique imaging features present challenges to conventional imaging metrics. The heterogeneous nature of these tumors, with a variable composition (fibrous, myxoid, or cellular), complicates accurate delineation of tumor boundaries and volumetric assessment. Furthermore, desmoid tumors can demonstrate prolonged stability or spontaneous regression, and biologic quiescence is often manifested by collagenization rather than bulk size reduction, making traditional size-based response criteria, such as Response Evaluation Criteria in Solid Tumors (RECIST), suboptimal. To overcome these limitations, advanced imaging techniques offer promising opportunities. Functional and parametric imaging methods, such as diffusion-weighted MRI, dynamic contrast-enhanced MRI, and T2 relaxometry, can provide insights into tumor cellularity and maturation. Radiomics and artificial intelligence approaches may enhance quantitative analysis by extracting and correlating complex imaging features with biological behavior. Moreover, imaging biomarkers could facilitate earlier detection of treatment efficacy or resistance, enabling tailored therapy. By integrating advanced imaging into clinical practice, it may be possible to refine the evaluation of disease burden and treatment response, ultimately improving the management and outcomes of patients with desmoid tumors.
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spelling doaj-art-bf5e2df8dffb4b30a8a1e8c08c44d1e12025-08-20T02:33:31ZengMDPI AGCurrent Oncology1198-00521718-77292025-05-0132528810.3390/curroncol32050288The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic ResponseYu-Cherng Chang0Bryan Nixon1Felipe Souza2Fabiano Nassar Cardoso3Etan Dayan4Erik J. Geiger5Andrew Rosenberg6Gina D’Amato7Ty Subhawong8Department of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Orthopaedics, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Pathology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USADesmoid tumors are rare, locally invasive soft-tissue tumors with unpredictable clinical behavior. Imaging plays a crucial role in their diagnosis, measurement of disease burden, and assessment of treatment response. However, desmoid tumors’ unique imaging features present challenges to conventional imaging metrics. The heterogeneous nature of these tumors, with a variable composition (fibrous, myxoid, or cellular), complicates accurate delineation of tumor boundaries and volumetric assessment. Furthermore, desmoid tumors can demonstrate prolonged stability or spontaneous regression, and biologic quiescence is often manifested by collagenization rather than bulk size reduction, making traditional size-based response criteria, such as Response Evaluation Criteria in Solid Tumors (RECIST), suboptimal. To overcome these limitations, advanced imaging techniques offer promising opportunities. Functional and parametric imaging methods, such as diffusion-weighted MRI, dynamic contrast-enhanced MRI, and T2 relaxometry, can provide insights into tumor cellularity and maturation. Radiomics and artificial intelligence approaches may enhance quantitative analysis by extracting and correlating complex imaging features with biological behavior. Moreover, imaging biomarkers could facilitate earlier detection of treatment efficacy or resistance, enabling tailored therapy. By integrating advanced imaging into clinical practice, it may be possible to refine the evaluation of disease burden and treatment response, ultimately improving the management and outcomes of patients with desmoid tumors.https://www.mdpi.com/1718-7729/32/5/288desmoid tumorMRIradiomicsbiomarkersRECIST
spellingShingle Yu-Cherng Chang
Bryan Nixon
Felipe Souza
Fabiano Nassar Cardoso
Etan Dayan
Erik J. Geiger
Andrew Rosenberg
Gina D’Amato
Ty Subhawong
The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
Current Oncology
desmoid tumor
MRI
radiomics
biomarkers
RECIST
title The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
title_full The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
title_fullStr The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
title_full_unstemmed The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
title_short The Desmoid Dilemma: Challenges and Opportunities in Assessing Tumor Burden and Therapeutic Response
title_sort desmoid dilemma challenges and opportunities in assessing tumor burden and therapeutic response
topic desmoid tumor
MRI
radiomics
biomarkers
RECIST
url https://www.mdpi.com/1718-7729/32/5/288
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