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Clinical impact of whole-body MRI in staging and surveillance of patients with myxoid liposarcoma: a 14-year single-centre retrospective study

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To assess the clinical impact of regular whole-body magnetic resonance imaging (WBMRI) surveillance in myxoid liposarcoma patients.

Methods

This was a retrospective cohort study of myxoid liposarcoma patients who underwent at least one WBMRI at our institution between October 2006 and December 2020. The effect of WBMRI on clinical management, namely treatment modification or additional diagnostic investigations was studied. A standardised WBMRI surveillance protocol was instituted in 2015. We compared patient outcomes for the metastatic patients who had and had not received regular WBMRI surveillance and performed survival analysis for both subgroups.

Results

Of the 56 patients (60.7% male, median age: 48.1 years) who underwent 345 WBMRI, 17 (30.3%) had metastases, and 168 WBMRI were performed in this group. The median imaging follow-up for the entire cohort was 35 months; the metastatic group had a median follow-up of 42 months. WBMRI changed the clinical management in 13 (76.5%) metastatic patients, with 33 instances of treatment modification. Thirty-five lesions were labelled ‘indeterminate,’ 16 (45.7%) had additional investigations/interventions, and 4 (11.4%) were confirmed to be metastatic. Twenty-one metastatic lesions were missed initially on WBMRI and confirmed on subsequent WBMRI, of which 5 (23.8%) were clinically significant. The 5-year survival since the detection of metastasis was better in the regular surveillance subgroup (85.7% vs. 45%), but this was not statistically significant (p = 0.068). Five patients (8.9%) developed their first metastasis more than 5 years after diagnosing the primary lesion.

Conclusion

Regular WBMRI surveillance of myxoid liposarcoma patients considerably impacts clinical management by frequently influencing treatment decisions.

Clinical relevance statement

WBMRI has been recently recommended as an imaging option for the staging and surveillance of myxoid liposarcoma patients. Our study highlights the impact of regular WBMRI surveillance on the clinical management of these patients and how it affects their survival.

Key Points

  • Current screening recommendations for myxoid liposarcoma patients, including WBMRI, are equivocal.

  • WBMRI surveillance modified treatment in about 75% of metastatic myxoid liposarcoma patients and was associated with improved survival.

  • A number of delayed metastasis were observed, suggesting the need for extending the period of WBMRI surveillance.

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Abbreviations

ESMO:

European Society for Medical Oncology

MLS:

Myxoid liposarcoma

NCCN:

National Comprehensive Cancer Network

WBMRI:

Whole-body magnetic resonance imaging

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. York and Scarborough Teaching Hospitals NHS Foundation Trust, York, United Kingdom

    Samir Paruthikunnan

  2. Department of Radiology, McGill University Health Centre, Montreal, Canada

    Natalia Gorelik & Thomas I. Powell

  3. Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Canada

    Robert E. Turcotte

  4. Department of Pathology, McGill University Health Centre, Montreal, Canada

    Sungmi Jung

  5. Department of Medical Oncology, McGill University Health Centre, Montreal, Canada

    Thierry Alcindor

Authors
  1. Samir Paruthikunnan
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  2. Natalia Gorelik
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  3. Robert E. Turcotte
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  4. Sungmi Jung
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  5. Thierry Alcindor
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  6. Thomas I. Powell
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Corresponding author

Correspondence to Samir Paruthikunnan.

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Guarantor

The scientific guarantor of this publication is Dr Thomas I. Powell.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some of our study subjects (n = 56) have been previously reported in Gorelik N, Reddy SMV, Turcotte RE, Goulding K, Jung S, Alcindor T, et al Early detection of metastases using WBMRI for initial staging and routine follow-up of myxoid liposarcoma (n = 33). Skeletal Radiol (Internet). 2018 March 1. The study performed by Gorelik et al aimed to assess how WBMRI helped in the early diagnosis of myxoid liposarcoma metastases, while our study aims to assess the impact WBMRI surveillance has had over the clinical management of myxoid liposarcoma patients, highlights the presence of delayed metastases requiring extended WBMRI surveillance and also evaluates the survival rates in the metastatic patients with and without regular WBMRI surveillance.

Methodology

  • Retrospective

  • Observational

  • Performed at one institution

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Paruthikunnan, S., Gorelik, N., Turcotte, R.E. et al. Clinical impact of whole-body MRI in staging and surveillance of patients with myxoid liposarcoma: a 14-year single-centre retrospective study. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10752-1

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  • DOI: https://doi.org/10.1007/s00330-024-10752-1

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