Single-site disease progression after 9 months of response to therapy in the right hemipelvis visualized by diffusion-weighted whole-body MRI. Top, fusion.

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Single-site disease progression after 9 months of response to therapy in the right hemipelvis visualized by diffusion-weighted whole-body MRI. Top, fusion of the T1-weighted imaging and diffusion-weighted imaging; bottom, apparent diffusion coefficient (ADC... Single-site disease progression after 9 months of response to therapy in the right hemipelvis visualized by diffusion-weighted whole-body MRI. Top, fusion of the T1-weighted imaging and diffusion-weighted imaging; bottom, apparent diffusion coefficient (ADC) maps. Areas of high signal on diffusion-weighted imaging and low ADC values indicate tumor bone marrow infiltration. Left, baseline MRI scan, showing diffuse tumor infiltration in the pelvic bone. The first trial biopsy was taken from the left iliac bone (red circle) and identified a deleterious BRCA2 mutation with LOH. After 12 weeks of therapy (middle), there was a major response to therapy reported. After 9 months (right), the MRI identified a focal area of tumor relapse in the right iliac bone, which was biopsied (red arrow). Next-generation sequencing of this biopsy confirmed a de novo mutation in BRCA2 restoring the open reading frame. Jane Goodall et al. Cancer Discov 2017;7:1006-1017 ©2017 by American Association for Cancer Research