Detection of Soft-Tissue Sarcoma Recurrence: Added Value of Functional MR Imaging Techniques at 3.0 T

Grande, Filippo Del; Subhawong, Ty K.; Weber, Kristy; Aro, Michael; Mugera, Charles; Fayad, Laura M.

doi:10.1148/radiol.13130844

Cited by 121 publications

(112 citation statements)

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“…On dynamic contrastenhanced MRI, rapid arterial enhancement followed by a plateau or washout phase has been reported to favour malignancy [7]. There have been inconsistent reports [8][9][10][11][12][13][14] using diffusion-weighted imaging (DWI) at 1.5 T for differentiation of malignant from benign soft tissue tumours. Benign lesions such as lipoma, epidermal inclusion cyst, and localized tenosynovial giant cell tumour (giant cell tumour of tendon sheath) can have low apparent diffusion coefficients (ADCs), while malignant tumours with myxoid or chondroid components have high ADCs [10,11,15].…”

Section: Introductionmentioning

confidence: 99%

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T

et al. 2015

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Objectives To determine the added value of diffusionweighted imaging (DWI) to standard magnetic resonance imaging (MRI) to differentiate malignant from benign soft tissue tumours at 3.0 T. Methods 3.0 T MR images including DWI in 63 patients who underwent surgery for soft tissue tumours were retrospectively analyzed. Two readers independently interpreted MRI for the presence of malignancy in two steps: standard MRI alone, standard MRI and DWI with qualitative and quantitative analysis combined. Results There were 34 malignant and 29 non-malignant soft tissue tumours. In qualitative analysis, hyperintensity relative to skeletal muscle was more frequent in malignant than benign tumours on DWI (P=0.003). In quantitative analysis, ADCs of malignant tumours were significantly lower than those of nonmalignant tumours (P≤0.002): 759±385 vs. 1188±423 μm 2 / sec minimum ADC value, 941±440 vs. 1310±440 μm 2 /sec average ADC value. The mean sensitivity, specificity and accuracy of both readers were 96 %, 72 %, and 85 % on standard MRI alone and 97 %, 90 %, and 94 % on standard MRI with DWI.Conclusions The addition of DWI to standard MRI improves the diagnostic accuracy for differentiation of malignant from benign soft tissue tumours at 3.0 T. Key Points • DWI has added value for differentiating malignant from benign soft tissue tumours. • Addition of DWI to standard MRI at 3.0 T improves the diagnostic accuracy. • Measurements of both ADC min within solid portion and ADC av are helpful.

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Section: Introductionmentioning

confidence: 99%

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T

et al. 2015

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“…Postoperativ entzündlich alteriertes Gewebe oder Fibrose können raumfordernd sein, weisen in der dynamischen KM-Sequenz jedoch fast nie ein arterielles Enhancement auf (Spezifität von 97 % für Rezidiv) [33].…”

Section: Posttherapeutische Reguläre Veränderungen Und Komplikationenunclassified

“…Die Diffusionskapazität ist einer Studie zufolge in Hämatomen signifikant höher als bei Weichteilsarkomrezidiven oder Pseudotumoren [33].…”

Section: Hämatomeunclassified

“…Umschriebene hyperintense Läsionen sollten weiter mit T1-gewichteten Sequenzen und Gadoliniumgabe abgeklärt werden [65], bevorzugt unter Einbeziehung von Subtraktionsbildern: Die KM-Aufnahme beweist das Vorliegen von solidem Gewebe. Besonders spezifisch ist der Nachweis einer arteriellen Anflutung im Tumor in der dynamischen KM-Sequenz, der postoperativ entzündlich alteriertes oder fibrotisches Gewebe zu 97 % ausschließt [33,91].…”

Section: Lokalrezidiveunclassified

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Weichteilsarkome: Wie lassen sich posttherapeutische Veränderungen von Rezidiven unterscheiden?

Noebauer-Huhmann

Grieser

2017

Radiologe

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Die Diagnostik und Therapie von Patienten mit Weichteiltumoren konnte in den letzten Jahrzehnten verbessert werden, auch durch interdisziplinär in Tumorboards abgesprochenes optimiertes und standardisiertes Vorgehen [10,18,25,36,92]. Dadurch konnten bei Extremitätensarkomen sehr niedrige Lokalrezidivraten von nur 4,1 % nach 5 Jahren erreicht werden, in einer anderen Studie mit extremitätenerhaltender Resektion und postoperativer Radiatio Raten von 9 % nach 5 bzw. 12 % nach 10 Jahren [25,60] [23,56,60,99].

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“…DW imaging with ADC mapping is a well-known technique for characterizing lesions according to their degree of cellularity (14). Low ADC values are present in cellular malignant tumors such as sarcoma, whereas higher ADC values are found in hypocellular regions such as inflammatory edema (15).…”

Section: A a B B C Cmentioning

confidence: 99%

Large Vessel Vasculitis with an Isolated Lesion of a Single-lobe Pulmonary Artery

et al. 2016

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Chronic pulmonary arterial obstructions are caused mostly by chronic pulmonary artery thromboembolism and rarely by vasculitis or intimal sarcoma of the pulmonary artery. We herein report an unusual case of a 42-year-old woman with a solitary obstruction of the pulmonary artery in the right lower lobe of her lung. Because we could not exclude the possibility of intimal sarcoma, middle and lower lobectomy was performed. The resected specimens revealed large vessel vasculitis (LVV) and an isolated lesion in the right lower lobe pulmonary artery. LVV should therefore be considered in the differential diagnosis for single pulmonary arterial stenosis or obstruction.

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Detection of Soft-Tissue Sarcoma Recurrence: Added Value of Functional MR Imaging Techniques at 3.0 T

Abstract: The addition of functional MR sequences to a routine MR protocol, in particular DCE MR imaging, offers a specificity of more than 95% for distinguishing recurrent sarcoma from postsurgical scarring.

Cited by 121 publications

References 20 publications

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T

Weichteilsarkome: Wie lassen sich posttherapeutische Veränderungen von Rezidiven unterscheiden?

Large Vessel Vasculitis with an Isolated Lesion of a Single-lobe Pulmonary Artery

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