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Coefficient of variation of T2-weighted MRI may predict the prognosis of malignant peripheral nerve sheath tumor

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Background

We investigated whether non-enhancement MRI features, including measurement of the heterogeneity of the tumor with MR T2 imaging by calculating coefficient of variation (CV) values, were associated with the prognosis of non-metastatic malignant peripheral nerve sheath tumors (MPNST).

Methods

This retrospective study included 42 patients with MPNST who had undergone surgical resection (mean age, 50 years ± 21; 20 male participants). Non-enhancement MR images were evaluated for signal intensity heterogeneity on T1- and T2-weighted imaging, tumor margin definition on T1- and T2-weighted imaging, peritumoral edema on T2-weight imaging, and CV. We measured the signal intensities of MR T2-weighted images and calculated the corresponding CV values. CV is defined as the ratio of the standard deviation to the mean. The associations between factors and overall survival (OS) were investigated via the Kaplan–Meier method with log-rank tests and the Cox proportional hazards model.

Results

The mean CV value of MR T2 images was 0.2299 ± 0.1339 (standard deviation) (range, 0.0381–0.8053). Applying receiver operating characteristics analysis, the optimal cut-off level for CV value was 0.137. This cut-off CV value was used for its stratification into high and low CV values. At multivariate survival analysis, a high CV value (hazard ratio = 3.63; 95% confidence interval = 1.16–16.0; p = 0.047) was identified as an independent predictor of OS.

Conclusion

The CV value of the signal intensity of heterogenous MPNSTs MR T2-weighted images is an independent predictor of patients’ OS.

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Data availability

The datasets supporting the conclusions of this article are included within the article. Additional datasets used for the current study are available from the corresponding author upon request.

Abbreviations

CV:

Coefficient of variation

MPNST:

Malignant peripheral nerve sheath tumor

NF:

Neurofibromatosis

OS:

Overall survival

ROI:

Region of interest

STS:

Soft tissue sarcoma

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Acknowledgements

The authors would like to thank Tomoko Sonoda, PhD, for statistical analyses.

Funding

This work was partly supported by grants from JSPS KAKENHI (20K09506 and 23K08657 to M. Emori).

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo-Ku, Sapporo, 060-8543, Japan

    Makoto Emori, Atsushi Teramoto, Yasutaka Murahashi, Ryosuke Hirota, Naoya Nakahashi, Junya Shimizu & Toshihiko Yamashita

  2. Department of Orthopedic Surgery, Akita University School of Medicine, Akita, Akita, 010-8543, Japan

    Hiroyuki Tsuchie, Hiroyuki Nagasawa & Naohisa Miyakoshi

  3. Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, 060-0812, Japan

    Hiroyuki Takashima

  4. Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan

    Yoshinori Imura, Hidetatsu Outani & Seiji Okada

  5. Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka, Osaka, 541-8567, Japan

    Sho Nakai & Satoshi Takenaka

  6. Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8543, Japan

    Kazuyuki Murase & Kohichi Takada

  7. Departments of Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8543, Japan

    Akira Takasawa

  8. Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8543, Japan

    Shintaro Sugita & Tadashi Hasegawa

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  1. Makoto Emori
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  2. Hiroyuki Tsuchie
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  20. Naohisa Miyakoshi
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  21. Toshihiko Yamashita
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Corresponding author

Correspondence to Makoto Emori.

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Ethics approval and consent to participate

The research was approved by the Institutional Review Board for Clinical Research at our university (reference number 332–198; March 10, 2022) and complied with the relevant requirements in the Declaration of Helsinki.

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The authors declare no competing interests.

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Emori, M., Tsuchie, H., Takashima, H. et al. Coefficient of variation of T2-weighted MRI may predict the prognosis of malignant peripheral nerve sheath tumor. Skeletal Radiol 53, 657–664 (2024). https://doi.org/10.1007/s00256-023-04457-7

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  • DOI: https://doi.org/10.1007/s00256-023-04457-7

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