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The value of magnetic resonance imaging in the differentiation between malignant peripheral nerve-sheath tumors and non-neurogenic malignant soft-tissue tumors

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Abstract

Objective

To assess the sensitivity and specificity of MRI criteria in the differentiation between malignant peripheral nerve sheath tumors (MPNST) and non-neurogenic malignant soft-tissue tumors (MSTT).

Design and patients

MRI examinations of 105 patients with pathologically proven malignant soft-tissue lesions (35 MPNST and 70 MSTT) were retrospectively reviewed, the reviewers being unaware of the pathological diagnosis. Using a standardized protocol, the tumors were evaluated for multiple parameters regarding morphology and appearance on different sequences before and after gadolinium contrast administration (location, distribution, delineation, homogeneity, size, shape, relationship to bone and neurovascular bundle, intralesional hemorrhage, necrosis, perilesional edema, lymphangitis and signal intensities). Results were compared using a chi-square or Fisher’s exact test.

Results

MRI findings suggestive of MPNST (p<0,05) were intermuscular distribution, location on the course of a large nerve, nodular morphology, and overall non-homogeneity on T1-weighted images, T2-weighted images and T1-weighted images after gadolinium contrast injection. MRI findings in favor of MSTT were intramuscular distribution, ill-delineated appearance of more than 20% of the lesion’s circumference, and presence of intralesional blood vessels, perilesional edema and lymphangitis. There is no significant difference for degree and pattern of enhancement after gadolinium contrast injection, nor for presence of bone involvement or cystic or necrotic areas.

Conclusion

MRI provides several features that contribute to the differentiation between MPNST and non-neurogenic malignant soft-tissue tumors. MRI findings suggestive of MPNST should be helpful to pathologists in the strategy for further examination.

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References

  1. Gielen JL, De Schepper AM, Vanhoenacker F, et al. Accuracy of MRI in characterization of soft tissue tumors and tumor-like lesions. A prospective study in 548 patients. Eur Radiol 2004;14:2320–2330

    Article  Google Scholar 

  2. Van Rijswijk CSP, Geirnaerdt MJA, Hogendoorn PCW, et al. Soft tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy. Radiology 2004;233:493–502

    Article  Google Scholar 

  3. Moulton JS, Blebea JS, Dunco DM, Braley SE, Bisset GS, Emery KH. MR imaging of soft tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions. AJR Am J Roentgenol 1995;164:1191–1199

    Article  CAS  Google Scholar 

  4. Kransdorf MJ, Murphey MD. Radiologic evaluation of soft tissue masses. AJR Am J Roentgenol 2000;175:575–587

    Article  CAS  Google Scholar 

  5. Kransdorf MJ, Jelinek JS, Moser RP, et al. Soft tissue masses : diagnosis using MR imaging. AJR Am J Roentgenol 1989;153:541–547

    Article  CAS  Google Scholar 

  6. Totty WG, Murphy WA, Lee JKT. Soft tissue tumors: MR imaging. Radiology 1986;160:135–141

    Article  CAS  Google Scholar 

  7. Petasnick JP, Turner DA, Charters JR, Gitelis S, Zacharias CE. Soft tissue masses of the locomotor system: comparison of MR imaging with CT. Radiology 1986;160:125–133

    Article  CAS  Google Scholar 

  8. Lin J, Martel W. Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging and sonography. AJR Am J Roentgenol 2001;176:75–82

    Article  CAS  Google Scholar 

  9. Anderson MW, Temple HT, Dussault RG, Kaplan PA. Compartmental anatomy: relevance to staging and biopsy of musculoskeletal tumors. AJR Am J Roentgenol 1999;173:1663–1667

    Article  CAS  Google Scholar 

  10. Özgül T, Taner Y, Oguz Ö. Giant malignant peripheral nerve sheath tumor of the neck in a patient with neurofibromatosis-1. Int J Pediatr Otorhinolaryngol 2004;68:1465–1467

    Article  Google Scholar 

  11. Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999;19:1253–1280

    Article  CAS  Google Scholar 

  12. Saifuddin A. Imaging tumours of the brachial plexus. Skel Radiol 2003;32:375–387

    Article  Google Scholar 

  13. Enzinger FM, Weiss SW. Soft tissue tumors. 4th edn. St Louis: Mosby; 2001

    Google Scholar 

  14. Wick MR, Swanson PE, Scheithauer BW, et al. Malignant peripheral nerve sheath tumor, an immunohistochemical study of 62 cases. Am J Clin Pathol 1987;87:425–133

    Article  Google Scholar 

  15. Parizel PM, Simoens WA, Matos C, Verstraete KL. Tumors of peripheral nerves nerves. In: De Schepper AM, editor. Imaging of soft tissue tumors. 2nd edn. Berlin Heidelberg New York: Springer ;2001. pp 301–328

    Chapter  Google Scholar 

  16. Ogose A, Hotta T, Morita T, et al. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features and histologic diagnosis. Skel Radiol 1999;28:183–188

    Article  CAS  Google Scholar 

  17. Suh JS, Abenoza P, Galloway HR, et al. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology 1992;183:341–346

    Article  CAS  Google Scholar 

  18. Isobe K, Shimizu T, Akahane T, Kato H. Imaging of ancient schwannoma. AJR Am J Roentgenol2004;183:331–336

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium

    B. H. Van Herendael, S. R. G. Heyman, F. M. Vanhoenacker, P. M. Parizel & A. M. De Schepper

  2. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    G. De Temmerman & J. L. Bloem

Authors
  1. B. H. Van Herendael
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  2. S. R. G. Heyman
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  3. F. M. Vanhoenacker
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  4. G. De Temmerman
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  5. J. L. Bloem
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  6. P. M. Parizel
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  7. A. M. De Schepper
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Correspondence to B. H. Van Herendael.

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Van Herendael, B.H., Heyman, S.R.G., Vanhoenacker, F.M. et al. The value of magnetic resonance imaging in the differentiation between malignant peripheral nerve-sheath tumors and non-neurogenic malignant soft-tissue tumors. Skeletal Radiol 35, 745–753 (2006). https://doi.org/10.1007/s00256-006-0160-y

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  • DOI: https://doi.org/10.1007/s00256-006-0160-y

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