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Background: Desmoid tumors can cause morbidity due to local invasion, potentially being fatal when fast growth compromises vital structures. In this context, a timely treatment response is required. This study aims to compare the activity of sorafenib and anthracycline‐containing regimens during the first year of treatment. Methods: The authors conducted a multi‐institutional retrospective analysis of desmoid tumor patients treated with either sorafenib or an anthracycline‐containing regimen over 1 year. The primary end point was the overall response rate (ORR). The secondary end points were time to response (TTR), progression‐free survival (PFS), and adverse events. Results: From 2005 to 2022, 80 patients received sorafenib and 51 received an anthracycline‐containing regimen with similar baseline characteristics. The 1‐year ORR was 37% for anthracycline and 13% for sorafenib (p =.016). Median best response was –9% (range, –73 to 51) for anthracycline and –4% (range, –69 to 126) for sorafenib. Median TTR was 5.6 months (95% confidence interval [CI], 3.4–7.8) for anthracycline and 8.7 months (95% CI, 6.3–11.1) for sorafenib (p =.2). One‐year PFS was 73% (95% CI, 60–86) for anthracycline and 59% (95% CI, 47–71) for sorafenib (p =.3). Common grade 1–2 adverse events for sorafenib were hand‐foot syndrome (40%), diarrhea (25%), and fatigue (22%); for anthracycline, they were nausea (31%), fatigue (16%), and rash (14%). Grade 3 events were higher in the anthracycline group, 27% versus 14% (p <.05). Conclusion: Anthracycline‐based therapy provided a greater 1‐year response rate than sorafenib but was associated with a higher rate of serious adverse events. Higher‐risk desmoid tumors, which need a more timely response, might benefit from anthracycline‐based therapies, whereas average‐risk tumors could benefit from sorafenib. This article reports a multi‐institutional retrospective comparison of the activity between sorafenib and anthracycline‐based chemotherapies for desmoid tumors. It shows that anthracycline‐based chemotherapies can produce a greater proportion of responses in the first year of treatment at the expense of greater toxicity. [ABSTRACT FROM AUTHOR]

Limb salvage surgeries utilizing endoprostheses and allografts are performed for a variety of oncologic conditions. These reconstructions can fail and require revision for many reasons, which are outlined and classified into mechanical failures (soft tissue failures, aseptic loosening, structural failure), non-mechanical failures (infection, tumor progression), and pediatric failures (physeal arrest, growth dysplasia). Distinct radiologic and clinical findings define specific failure subtypes but are sparsely illustrated in the radiology literature. Specifically, an understanding of the organizational structure of the failure modes can direct radiologists' search for post-reconstruction complications, enhance an appreciation of their prognostic significance, and facilitate research by standardizing the language and conceptual framework around outcomes. The purpose of this review is to highlight the key radiologic findings and imaging studies of each failure mode in orthopedic oncologic reconstructive surgery in the context of risk factors, failure rates, prognosis and survival statistics, and clinical decision-making regarding chemotherapy, radiation, and revision surgery. [ABSTRACT FROM AUTHOR]

Pseudolesions in bone and muscle are encountered mostly incidentally in routine imaging studies, especially due to the recent advancements on many different imaging modalities. These lesions can be categorized into the following categories: normal variants; congenital; iatrogenic; degenerative; and postoperative. In this review, we discuss the many different radiological characteristics of musculoskeletal pseudolesions that appear on imaging, which can prevent non-essential additional studies. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcomas are a heterogeneous group of tumors that arise from mesenchymal tissue, including adipose, bone, cartilage, skeletal muscle, and smooth muscle. Because of their rarity, optimal treatment planning requires discussion among sarcoma-experienced subspecialists. Studies have shown that treatment guided by multidisciplinary tumor boards (MTBs) is associated with better compliance with clinical practice guidelines and, in some cases, increased survival. The role of radiologists in the MTB setting is valuable in assessing disease in patients with sarcoma; however, radiologists' recommendations may differ from the MTB's consensus. This study highlights the discordance between the disease assessment and the clinical recommendations provided by radiologists and MTBs and encourages all radiologists caring for patients with sarcoma to participate in MTBs to best align their interpretations with optimal clinical management and make multidisciplinary aligned recommendations whenever feasible. Multidisciplinary tumor boards (MTBs) facilitate decision-making among subspecialists in the care of oncology patients, but the mechanisms by which they enhance outcomes remain incompletely understood. Our aim was to measure the agreement between sarcoma MTBs and radiology reports' disease assessment and management recommendations. This single-center IRB-approved retrospective study evaluated cases presented at a weekly sarcoma MTB from 1 August 2020 to 31 July 2021. Cases without clinical notes, imaging studies, or radiology reports were excluded. The data collected included the patient's clinical status at the time of the MTB, the treatment response assessment by the MTB and radiologists (stable disease; partial response; complete response; progressive disease/recurrence), and the recommendations of the radiology reports and of the MTB. The agreement between the initial radiologist review and MTB on disease assessment and recommendations was analyzed using kappa statistics. In total, 283 cases met the inclusion criteria. Radiology reports provided recommendations in 34.3% of cases, which were adhered to by the ordering providers in 73.2% of cases. The agreement between MTBs and radiology reports was moderate in disease assessment (86.2% agreement; κ = 0.78; p < 0.0001) and negligible in recommendations (36% agreement; κ = 0.18; p < 0.0001). Radiologists were more likely to assign progressive disease/recurrence than MTBs (54.4% vs. 44.4%; p < 0.001) and to recommend short-term imaging follow-up more commonly than MTBs (46.4% vs. 21.7%; p < 0.001). At a tertiary care center, radiologists' isolated interpretations of imaging findings and management recommendations frequently differ from the MTB's consensus, reflecting the value of multidisciplinary discussions incorporating the patient's clinical status and the available treatment options into the final radiographic assessment. [ABSTRACT FROM AUTHOR]

Objectives: Because size-based imaging criteria poorly capture biologic response in desmoid-type fibromatosis (DF), changes in MRI T2 signal intensity are frequently used as a response surrogate, but remain qualitative. We hypothesized that absolute quantification of DF T2 relaxation time derived from parametric T2 maps would be a feasible and effective imaging biomarker of disease activity. Methods: This IRB-approved retrospective study included 11 patients with DF, managed by observation or systemic therapy, assessed by 3T MRI. Tumor maximum diameter, volume, and T2-weighted signal intensity were derived from manual tumor segmentations. Tumor:muscle T2 signal ratios were recorded. Two readers measured tumor T2 relaxation times using a commercial T2 scanning sequence, manual ROI delineation and commercial calculation software enabling estimation of reader reliability. Objective response rates based on RECIST1.1 and best responses were compared between sizebased and signal-based parameters. Results: Median patient age was 52.6 years; 8 subjects were female (73%). Nine patients with longitudinal assessments were followed for an average of 314 days. Median baseline tumor diameter was 7.2 cm (range 4.4 - 18.2 cm). Median baseline T2 was 65.1 ms (range 40.4 - 94.8 ms, n=11); median at last follow-up was 44.3 ms (-32% from baseline; range 29.3 - 94.7 ms, n=9). T2 relaxation times correlated with tumor:muscle T2 signal ratios, Spearman p=0.78 (p<0.001). T2 mapping showed high inter-reader reliability, ICC=0.84. The best response as a percentage change in T2 values was statistically significant (mean -17.9%, p=0.05, paired t-test) while change in diameter was not (mean -8.9%, p=0.12). Conclusions: Analysis of T2 relaxation time maps of DF may offer a feasible quantitative biomarker for assessing the extent of response to treatment. This approach may have high inter-reader reliability. [ABSTRACT FROM AUTHOR]

Hyperflexion injury to the metatarsophalangeal joint of the great toe, referred to as sand toe, can cause significant functional impairment. To our knowledge, there have been no radiological descriptions of this injury in the paediatric age group. Here, we report radiographic, sonographic and MRI findings in a male paediatric patient who sustained a sand toe injury, highlighting structural damage to the dorsomedial capsule and medial sagittal band, and discuss sand toe’s favourable prognosis with conservative management. [ABSTRACT FROM AUTHOR]