Subscribe to RSS
Download PDF
DOI: 10.4103/ijri.IJRI_251_17
Can MRI diffusion-weighted imaging identify postoperative residual/recurrent soft-tissue sarcomas?
Subject Editor:
Financial support and sponsorship Nil.
Abstract
Purpose: The aim of this study was to evaluate contrast-enhanced magnetic resonance imaging (CE-MRI) and quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in the detection of recurrent/residual postoperative soft tissue sarcomas. Materials and Methods: This study included 36 patients; 27 patients had postoperative recurrent/residual soft tissue sarcomas and 9 patients had postoperative and treatment-related changes (inflammation/fibrosis). The DWI was obtained with 3 b values including 0, 400, and 800 s/mm2. Calculation of the ADC value of the lesion was done via placing the region of interest (ROI) to include the largest area of the lesion. ADC values were compared to histopathology. Results: Our results showed that including CE-MRI improved the diagnostic accuracy and sensitivity in recurrence detection compared to conventional non-enhanced sequences. However, it showed low specificity (55.56%) with a high false-positive rate that may lead to an unnecessary biopsy of a mass such as region of postoperative scar tissue. Conclusion: The joint use of gadolinium-enhanced MRI and quantitative DWI with ADC mapping offer added value in the detection of recurrent/residual postoperative soft tissue sarcoma. This combined use increased both the diagnostic sensitivity and specificity with a cut-off average ADC value for detecting nonmyxoid recurrent/residual lesions ≤1.3 × 10−3 mm2/s (100% specificity and 90.48% sensitivity). Our results showed limited value of DWI with ADC mapping in assessing myxoid sarcomatous tumor recurrences.
Publication History
Article published online:
26 July 2021
© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Afonso PD, Kosinski AS, Spritzer CE. Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?. Eur J Radiol 2013; 82: 806-13
- 2 Del Grande F, Subhawong T, Weber K, Aro M, Mugera C, Fayad LM. Detection of soft-tissue sarcoma recurrence: Added value of functional MR imaging techniques at 3.0 T. Radiology 2014; 271: 499-511
- 3 Fayad LM, Jacobs MA, Wang X, Carrino JA, Bluemke DA. Musculoskeletal tumors: How to use anatomic, functional, and metabolic MR techniques. Radiology 2012; 265: 340-56
- 4 Khoo MM, Tyler PA, Saifuddin A, Padhani AR. Diffusion-weighted imaging (DWI) in musculoskeletal MRI: A critical review. Skelet Radiol 2011; 40: 665-818
- 5 Hickeson MP. Soft tissue sarcomas. In: Pediatric PET Imaging. Springer; New York: 2006: 302-11
- 6 Subhawong TK, Durand DJ, Thawait GK, Jacobs MA, Fayad LM. Characterization of soft tissue masses: Can quantitative diffusion weighted imaging reliably distinguish cysts from solid masses?. Skelet Radiol 2013; 42: 1583-92
- 7 Messiou C, Bonvalot S, Gronchi A, Vanel D, Meyer M, Robinson P. et al. Evaluation of response after pre-operative radiotherapy in soft tissue sarcomas; the European Organisation for Research and Treatment of Cancer–Soft Tissue and Bone Sarcoma Group (EORTC–STBSG) and Imaging Group recommendations for radiological examination and reporting with an emphasis on magnetic resonance imaging. Eur J Cancer 2016; 56: 37-44
- 8 Einarsdóttir H, Karlsson M, Wejde J, Bauer HC. Diffusion-weighted MRI of soft tissue tumours. Eur Radiol 2004; 14: 959-63
- 9 Razek A, Nada N, Ghaniem M, Elkhamary S. Assessment of soft tissue tumours of the extremities with diffusion echoplanar MR imaging. La Radiol Med 2012; 117: 96-101
- 10 Pekcevik Y, Kahya MO, Kaya A. Characterization of soft tissue tumors by diffusion-weighted imaging. Iran J Radiol 2015; 12
- 11 Nagata S, Nishimura H, Uchida M, Sakoda J, Tonan T, Hiraoka K. et al. Diffusion-weighted imaging of soft tissue tumors: Usefulness of the apparent diffusion coefficient for differential diagnosis. Radiat Med 2008; 26: 287-95
- 12 Subhawong TK, Jacobs MA, Fayad LM. Diffusion-weighted MR imaging for characterizing musculoskeletal lesions. Radiographics 2014; 34: 1163-77