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Baseline surveillance in Li Fraumeni syndrome using whole-body MRI: a systematic review and updated meta-analysis.
Dacoregio, Maria Inez; Abrahão Reis, Pedro Cotta; Gonçalves Celso, Davi Said; Romero, Lorena Escalante; Altmayer, Stephan; Vilbert, Maysa; Moraes, Fabio Ynoe; Gomy, Israel.
Afiliação
  • Dacoregio MI; State University of Centro Oeste (UNICENTRO), Guarapuava, PR, Brazil. mdacoregio@unicentro.edu.br.
  • Abrahão Reis PC; Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
  • Gonçalves Celso DS; Federal University of Viçosa (UFV), Viçosa, MG, Brazil.
  • Romero LE; Oncology Pediatrics Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
  • Altmayer S; Radiology Department, Stanford University, Stanford, CA, US.
  • Vilbert M; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, US.
  • Moraes FY; Radiation Oncology Department, Queen's University and Kingston Health Science Center, Kingston, ON, Canada.
  • Gomy I; Genetics Department, Faculdade de Medicina de Ribeirão Preto-USP RP, Ribeirão Preto, SP, Brazil.
Eur Radiol ; 2024 Jul 29.
Article em En | MEDLINE | ID: mdl-39075300
ABSTRACT

OBJECTIVES:

Li-Fraumeni syndrome (LFS) is a cancer syndrome associated with early-onset neoplasias. The use of whole-body magnetic resonance imaging (WBMRI) is recommended for regular cancer screening, however, evidence supporting the benefits in asymptomatic LFS patients is limited. This study aims to assess the clinical utility of WBMRI in germline TP53 mutation carriers at baseline and follow-up. MATERIALS AND

METHODS:

We systematically searched PubMed, Cochrane, and Embase databases for studies evaluating WBMRI as an early detection method for tumor screening in patients with LFS. We pooled the prevalence of the included variables along with their corresponding 95% confidence intervals (CIs). Statistical analyses were performed using R software, version 4.3.1.

RESULTS:

From 1687 results, 11 comprising 703 patients (359 females (51%); with a median age of 32 years (IQR 1-74)) were included. An estimated detection rate of 31% (95% CI 0.28, 0.34) for any suspicious lesions was found in asymptomatic TP53 carriers who underwent baseline WBMRI. A total of 277 lesions requiring clinical follow-up were identified in 215 patients. Cancer was confirmed in 46 lesions across 39 individuals. The estimated cancer diagnosis rate among suspicious lesions was 18% (95% CI 0.13, 0.25). WBMRI detected 41 of the 46 cancers at an early-disease stage, with an overall detection rate of 6% (95% CI 0.05, 0.08). The incidence rate was 2% per patient round of WBMRI (95% CI 0.01, 0.04), including baseline and follow-up.

CONCLUSION:

This meta-analysis provides evidence that surveillance with WBMRI is effective in detecting cancers in asymptomatic patients with LFS. CLINICAL RELEVANCE STATEMENT Our study demonstrates that whole-body MRI is an effective tool for early cancer detection in asymptomatic Li-Fraumeni Syndrome patients, highlighting its importance in surveillance protocols to improve diagnosis and treatment outcomes. KEY POINTS Current evidence for whole-body MRI screening of asymptomatic Li-Fraumeni Syndrome (LFS) patients remains scarce. Whole-body MRI identified 41 out of 46 cancers at an early stage, achieving an overall detection rate of 6%. Whole-body MRI surveillance is a valuable method for detecting cancers in asymptomatic LFS patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha