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Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade?

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Abstract

Objective

To determine if dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters reflect histological grade of soft tissue sarcoma (STS)

Materials and methods

The medical records of 50 patients diagnosed with pathologically confirmed STS were retrospectively reviewed. Each STS was assessed with conventional contrast-enhanced MRI and DCE-MRI using a 3.0-T MRI system. The conventional MRI characteristics of low-grade (grade 1) and high-grade (grade 2 and grade 3) tumors were analyzed. Semi-quantitative parameters, including iAUC and TTP, and quantitative parameters, including Ktrans, Kep, and Ve, were derived from DCE-MRI. The diagnostic performances and optimal thresholds of various combinations of DCE-MRI parameters for predicting histological grades of STS were investigated using receiver operator characteristic (ROC) curves.

Results

On conventional MRI, high-grade STSs were significantly larger (≥ 5 cm) and more likely to show a heterogeneous signal intensity on T2WI (> 75%), peritumoral hyperintensity on T2WI, or tumor necrosis (> 50%) compared with low-grade STS. On DCE-MRI, iAUC, TTP, Ktrans, and Kep were significant predictors of STS histological grade. Ktrans had a high diagnostic value for differentiating between high-grade and low-grade STSs. The combination of iAUC, TTP, and Ktrans yielded a higher AUC value (0.841) than the other models.

Conclusion

High-grade STSs were usually larger than low-grade STSs, had unclear boundaries, a heterogeneous signal intensity on T2-weighted image (T2WI), and extensive necrosis. On DCE-MRI, iAUC, TTP, Ktrans, and Kep could differentiate between high-grade and low-grade STSs. The combination of iAUC, TTP, and Ktrans had a high diagnostic performance for differentiating between STS histological grades.

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Author information

Author notes

  1. Xiangwen Li, Qimeng Wang and Yanping Dou contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning Province, China

    Xiangwen Li, Qimeng Wang, Yu Zhang, Lin Yang & Shaowu Wang

  2. Department of Ultrasound, The First Affiliated Hospital, Dalian Medical University, Dalian, China

    Yanping Dou

  3. Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, China

    Juan Tao

Authors
  1. Xiangwen Li
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  2. Qimeng Wang
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  3. Yanping Dou
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  4. Yu Zhang
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  5. Juan Tao
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  6. Lin Yang
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  7. Shaowu Wang
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Correspondence to Shaowu Wang.

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The study was approved by the ethics committee of our institution, which waived the need to obtain written informed consent from the included patients.

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Li, X., Wang, Q., Dou, Y. et al. Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade?. Skeletal Radiol 49, 1829–1838 (2020). https://doi.org/10.1007/s00256-020-03491-z

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  • DOI: https://doi.org/10.1007/s00256-020-03491-z

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