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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MDPI AG
2025-05-01
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| 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. |
| format | Article |
| id | doaj-art-bf5e2df8dffb4b30a8a1e8c08c44d1e1 |
| institution | OA Journals |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| 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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