Diffusion-Weighted Magnetic Resonance Imaging Improves the Accuracy of Differentiation of Benign from Malignant Peripheral Nerve Sheath Tumors

Koike, Hiroshi; Nishida, Yoshihiro; Ito, Shinji; Shimoyama, Yoshie; Ikuta, Kazunari; Urakawa, Hiroshi; Sakai, Takeharu; Shimizu, Koki; Ito, Kan; Imagama, Shiro

doi:10.1016/j.wneu.2021.09.130

Cited by 22 publications

(22 citation statements)

References 25 publications

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“…In six tumors, the diagnosis of neurofibroma was made by an intraoperative frozen section. The remaining 13 tumors were preoperatively determined to be neurofibroma based on MRI or 18 F-fluorodeoxyglucose positron emission tomography findings [ 18 , 19 , 20 ]. Postoperatively, all resected specimens were histologically analyzed and confirmed as neurofibroma by experienced pathologists through routine hematoxylin and eosin staining and immunohistochemical studies.…”

Section: Methodsmentioning

confidence: 99%

Surgical Treatment and Complications of Deep-Seated Nodular Plexiform Neurofibromas Associated with Neurofibromatosis Type 1

Ikuta

Nishida

Sakai

et al. 2022

JCM

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Background: Nodular plexiform neurofibromas in individuals with neurofibromatosis type 1 often cause significant symptoms and are treated with surgical excision despite the potential risk of complications. This study aimed to clarify the surgical outcomes of deep-seated nodular plexiform neurofibromas and identify the factors associated with postoperative complications. Methods: We retrospectively reviewed patients with neurofibromatosis type 1 who underwent surgical excision for deep-seated nodular plexiform neurofibromas in our hospital from 2015 to 2021. Enucleation while preserving the nerve fascicles was attempted first, and en bloc resection, ligating the nerve origin in cases in which the parent nerve was entrapped by the tumor, making the tumor difficult to dissect, was performed. Results: In 15 patients, 24 nodular plexiform neurofibromas received surgical excision. Sixteen tumors were enucleated, and eight were en bloc resected. The symptoms of all 10 patients with preoperative symptoms resolved after surgery. Four patients developed new neurological deficits immediately after surgery, two of whom had retained neurological symptoms at the last visit, but these symptoms were mild. Conclusions: The present study demonstrates that surgical treatment of nodular plexiform neurofibromas, even deep-seated neurofibromas, is safe with a low risk of severe complications and improvement in preoperative symptoms.

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Section: Methodsmentioning

confidence: 99%

Surgical Treatment and Complications of Deep-Seated Nodular Plexiform Neurofibromas Associated with Neurofibromatosis Type 1

Ikuta

Nishida

Sakai

et al. 2022

JCM

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Section: Malignant Peripheral Nerve Sheath Tumorsmentioning

confidence: 99%

Section: Malignant Peripheral Nerve Sheath Tumorsmentioning

confidence: 99%

“…However, because this feature was not a significant factor in all cases but in NF1 cases, they did not include this as one of the main useful features suggestive of malignancy (Wasa score). 38,46 Functional MRI using ADC mapping for differentiation between malignant and benign PNSTs has been studied several times. There were reports about the effectiveness of both minimum and mean ADC values in this differentiation.…”

Section: Malignant Peripheral Nerve Sheath Tumorsmentioning

confidence: 99%

“…Based on these observations, they concluded that the combination of the standard MRI findings (referred to as the Wasa score) and ADC map can improve the accuracy of differentiating MPNST from pNF. 46 Ahlawat and Fayad evaluated the role of the target sign on diffusion-weighted imaging (DWI) and ADC mapping for differentiation of BPNSTs from MPNSTs. They defined the target sign on DWI and ADC as a biphasic pattern of peripheral hyperintensity and homogeneous central hypointensity.…”

Section: Malignant Peripheral Nerve Sheath Tumorsmentioning

confidence: 99%

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Magnetic Resonance Imaging of Nerve Tumors

Behzad

Dianat

2022

Semin Musculoskelet Radiol

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Nerve tumors are uncommon soft tissue neoplasms predominantly arising from peripheral nerve sheath and Schwann cells. We review the manifestations of benign peripheral nerve sheath tumors, concentrating on distinguishing imaging features of schwannomas versus neurofibromas with an emphasis on treatment implications. Nevertheless, there is often an overlap between the imaging presentation of these two conditions, making the accurate radiologic diagnosis challenging. Therefore, tissue sampling is often needed for a definitive histologic diagnosis. Treatment planning largely depends on symptoms, location of the lesion, and underlying risk factors. Three major syndromes, neurofibromatosis type 1, type 2, and schwannomatosis, predispose patients to peripheral nerve sheath tumors (PNSTs), with particular concern about the malignant subtype expression. In patients with suspected PNSTs, correlation of imaging findings with clinical findings and genetic tests is helpful for a more accurate diagnosis and disease management. Some imaging features on magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography can be helpful to differentiate malignant from benign subtypes.

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