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Advanced magnetic resonance imaging (MRI) of soft tissue tumors: techniques and applications

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Abstract

Imaging evaluation of soft tissue tumors is important for the diagnosis, staging, and follow-up. Magnetic resonance imaging (MRI) is the preferred imaging modality due to its multiplanarity and optimal tissue contrast resolution. However, standard morphological sequences are often not sufficient to characterize the exact nature of the lesion, addressing the patient to an invasive bioptic examination for the definitive diagnosis. The recent technological advances with the development of functional MRI modalities such as diffusion-weighted imaging, dynamic contrast-enhanced perfusion imaging, magnetic resonance spectroscopy, and diffusion tensor imaging with tractography have implemented the multiparametricity of MR to evaluate in a noninvasive manner the biochemical, structural, and metabolic features of tumor tissues. The purpose of this article is to review the state of the art of these advanced MRI techniques, with focus on their technique and clinical application.

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References

  1. Beaman FD, Jelinek JS, Priebat DA (2013) Current imaging and therapy of malignant soft tissue tumors and tumor-like lesions. Semin Musculoskelet Radiol 17:168–176. https://doi.org/10.1055/s-0033-1343094

    Article  PubMed  Google Scholar 

  2. Barile A, Conti L, Lanni G et al (2013) Evaluation of medial meniscus tears and meniscal stability: weight-bearing MRI vs arthroscopy. Eur J Radiol 82:633–639. https://doi.org/10.1016/j.ejrad.2012.10.018

    Article  PubMed  Google Scholar 

  3. Barile A, Lanni G, Conti L et al (2013) Lesions of the biceps pulley as cause of anterosuperior impingement of the shoulder in the athlete: potentials and limits of MR arthrography compared with arthroscopy. Radiol Med 118:112–122. https://doi.org/10.1007/s11547-012-0838-2

    Article  CAS  PubMed  Google Scholar 

  4. Salvati F, Rossi F, Limbucci N et al (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. J Sports Med Phys Fitness 48:483–487

    CAS  PubMed  Google Scholar 

  5. Mariani S, La Marra A, Arrigoni F et al (2015) Dynamic measurement of patello-femoral joint alignment using weight-bearing magnetic resonance imaging (WB-MRI). Eur J Radiol 84:2571–2578. https://doi.org/10.1016/j.ejrad.2015.09.017

    Article  PubMed  Google Scholar 

  6. Barile A, Bruno F, Mariani S et al (2017) Follow-up of surgical and minimally invasive treatment of Achilles tendon pathology: a brief diagnostic imaging review. Musculoskelet Surg 101:51–61. https://doi.org/10.1007/s12306-017-0456-1

    Article  CAS  PubMed  Google Scholar 

  7. Barile A, Bruno F, Arrigoni F et al (2017) Emergency and trauma of the ankle. Semin Musculoskelet Radiol 21:282–289. https://doi.org/10.1055/s-0037-1602408

    Article  PubMed  Google Scholar 

  8. Zappia M, Castagna A, Barile A et al (2017) Imaging of the coracoglenoid ligament: a third ligament in the rotator interval of the shoulder. Skeletal Radiol 46:1101–1111. https://doi.org/10.1007/s00256-017-2667-9

    Article  PubMed  Google Scholar 

  9. Barile A, Arrigoni F, Bruno F et al (2017) Computed tomography and MR imaging in rheumatoid arthritis. Radiol Clin N Am. https://doi.org/10.1016/j.rcl.2017.04.006

    Article  PubMed  Google Scholar 

  10. Limbucci N, Rossi F, Salvati F et al (2010) Bilateral suprascapular nerve entrapment by glenoid labral cysts associated with rotator cuff damage and posterior instability in an amateur weightlifter. J Sports Med Phys Fitness 50:64–67

    CAS  PubMed  Google Scholar 

  11. Costa FM, Canella C, Gasparetto E (2011) Advanced magnetic resonance imaging techniques in the evaluation of musculoskeletal tumors. Radiol Clin N Am 49:1325–1358. https://doi.org/10.1016/j.rcl.2011.07.014

    Article  PubMed  Google Scholar 

  12. Bancroft L, Pettis C, Wasyliw C (2013) Imaging of benign soft tissue tumors. Semin Musculoskelet Radiol 17:156–167. https://doi.org/10.1055/s-0033-1343071

    Article  PubMed  Google Scholar 

  13. Teixeira PAG, Beaumont M, Gabriela H et al (2015) Advanced techniques in musculoskeletal oncology: perfusion, diffusion, and spectroscopy. Semin Musculoskelet Radiol 19:463–474. https://doi.org/10.1055/s-0035-1569250

    Article  PubMed  Google Scholar 

  14. Masciocchi C, Conti L, D'Orazio F et al (2012) Errors in musculoskeletal MRI. In: Errors in radiology. Springer, Italia. https://doi.org/10.1007/978-88-470-2339-0_18

    Chapter  Google Scholar 

  15. Subhawong TK, Jacobs MA, Fayad LM (2014) Insights into quantitative diffusion-weighted MRI for musculoskeletal tumor imaging. Am J Roentgenol 203:560–572. https://doi.org/10.2214/AJR.13.12165

    Article  Google Scholar 

  16. Russo F, Mazzetti S, Grignani G et al (2012) In vivo characterisation of soft tissue tumours by 1.5-T proton MR spectroscopy. Eur Radiol 22:1131–1139. https://doi.org/10.1007/s00330-011-2350-9

    Article  CAS  PubMed  Google Scholar 

  17. Masciocchi C, Lanni G, Conti L et al (2012) Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: potential and limits of diagnostic imaging. Skelet Radiol 41:643–649. https://doi.org/10.1007/s00256-011-1263-7

    Article  Google Scholar 

  18. Buchbender C, Heusner TA, Lauenstein TC et al (2012) Oncologic PET/MRI, part 2: bone tumors, soft-tissue tumors, melanoma, and lymphoma. J Nucl Med 53:1244–1252. https://doi.org/10.2967/jnumed.112.109306

    Article  PubMed  Google Scholar 

  19. Genovese E, Canì A, Rizzo S et al (2011) Comparison between MRI with spin-echo echo-planar diffusion-weighted sequence (DWI) and histology in the diagnosis of soft-tissue tumours. Radiol Med 116:644–656. https://doi.org/10.1007/s11547-011-0666-9

    Article  CAS  PubMed  Google Scholar 

  20. Aszmann OC (2015) Diffusion tensor tractography for the surgical management of peripheral nerve sheath tumors. Neurosurg Focus 39:1–6. https://doi.org/10.3171/2015.6.FOCUS15228

    Article  Google Scholar 

  21. Subhawong TK, Wilky BA (2015) Value added. Curr Opin Oncol 27:323–331. https://doi.org/10.1097/CCO.0000000000000199

    Article  CAS  PubMed  Google Scholar 

  22. Drapé JL (2013) Advances in magnetic resonance imaging of musculoskeletal tumours. Orthop Traumatol Surg Res 99:S115–S123. https://doi.org/10.1016/j.otsr.2012.12.005

    Article  PubMed  Google Scholar 

  23. Soldatos T, Fisher S, Karri S et al (2015) Advanced MR imaging of peripheral nerve sheath tumors including diffusion imaging theodoros. Semin Musculoskelet Radiol 19:179–190

    Article  PubMed  Google Scholar 

  24. Van Rijswijk CSP, Kunz P, Hogendoorn PCW et al (2002) Diffusion-weighted MRI in the characterization of soft-tissue tumors. J Magn Reson Imaging 15:302–307. https://doi.org/10.1002/jmri.10061

    Article  Google Scholar 

  25. Pozzi G, Albano D, Messina C et al (2017) Solid bone tumors of the spine: diagnostic performance of apparent diffusion coefficient measured using diffusion-weighted MRI using histology as a reference standard. J Magn Reson Imaging 47:1034–1042

    Article  PubMed  Google Scholar 

  26. Dietrich O, Raya JG, Sommer J et al (2005) A comparative evaluation of a RARE-based single-shot pulse sequence for diffusion-weighted MRI of musculoskeletal soft-tissue tumors. Eur Radiol 15:772–783. https://doi.org/10.1007/s00330-004-2619-3

    Article  PubMed  Google Scholar 

  27. Khoo MMY, Tyler PA, Saifuddin A, Padhani AR (2011) Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review. Skelet Radiol 40:665–681

    Article  Google Scholar 

  28. Oka K, Yakushiji T, Sato H et al (2011) Usefulness of diffusion-weighted imaging for differentiating between desmoid tumors and malignant soft tissue tumors. J Magn Reson Imaging 33:189–193. https://doi.org/10.1002/jmri.22406

    Article  PubMed  Google Scholar 

  29. Ahlawat S, Fayad LM (2015) De novo assessment of pediatric musculoskeletal soft tissue tumors: beyond anatomic imaging. Pediatrics 136:e194–e202. https://doi.org/10.1542/peds.2014-2316

    Article  PubMed  Google Scholar 

  30. Lee SY, Jee WH, Jung JY et al (2016) Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T. Eur Radiol 26:743–754. https://doi.org/10.1007/s00330-015-3878-x

    Article  PubMed  Google Scholar 

  31. Pekcevik Y, Kahya MO, Kaya A (2015) Characterization of soft tissue tumors by diffusion-weighted imaging. Iran J Radiol 12:1–6. https://doi.org/10.5812/iranjradiol.15478v2

    Article  Google Scholar 

  32. Demehri S, Belzberg A, Blakeley J, Fayad LM (2014) Conventional and functional MR imaging of peripheral nerve sheath tumors: initial experience. Am J Neuroradiol 35:1615–1620. https://doi.org/10.3174/ajnr.A3910

    Article  CAS  PubMed  Google Scholar 

  33. Jeon JY, Chung HW, Lee MH, Lee SH, Shin MJ (2016) Usefulness of diffusion-weighted MR imaging for differentiating between benign and malignant superficial soft tissue tumors and tumor-like lesions. Br Inst Radiol 89:20150929

    Article  Google Scholar 

  34. Oka K, Yakushiji T, Sato H et al (2008) Ability of diffusion-weighted imaging for the differential diagnosis between chronic expanding hematomas and malignant soft tissue tumors. J Magn Reson Imaging 28:1195–1200. https://doi.org/10.1002/jmri.21512

    Article  PubMed  Google Scholar 

  35. Barile A, Bruno F, Mariani S et al (2017) What can be seen after rotator cuff repair: a brief review of diagnostic imaging findings. Musculoskelet Surg. https://doi.org/10.1007/s12306-017-0455-2

    Article  PubMed  Google Scholar 

  36. De Filippo M, Pesce A, Barile A et al (2017) Imaging of postoperative shoulder instability. Musculoskelet Surg 101:15–22

    Article  PubMed  Google Scholar 

  37. Barile A, Regis G, Masi R et al (2007) Patologia neoplastica muscoloscheletrica: esperienza preliminare con RM perfusionale. Radiol Med 112:550–561. https://doi.org/10.1007/s11547-007-0161-5

    Article  CAS  PubMed  Google Scholar 

  38. Park MY, Jee W-H, Kim SK et al (2013) Preliminary experience using dynamic MRI at 3.0 Tesla for evaluation of soft tissue tumors. Korean J Radiol 14:102–109. https://doi.org/10.3348/kjr.2013.14.1.102

    Article  PubMed  Google Scholar 

  39. Barile A, Sabatini M, Iannessi F et al (2004) Pigmented villonodular synovitis (PVNS) of the knee joint: magnetic resonance imaging (MRI) using standard and dynamic paramagnetic contrast media. Report of 52 cases surgically and histologically controlled. Radiol Med 107:356–366

    PubMed  Google Scholar 

  40. van Rijswijk CSP, Geirnaerdt MJA, Hogendoorn PCW et al (2004) Soft-tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy. Radiology 233:493–502. https://doi.org/10.1148/radiol.2332031110

    Article  PubMed  Google Scholar 

  41. Zoccali C, Rossi B, Zoccali G et al (2015) A new technique for biopsy of soft tissue neoplasms: a preliminary experience using MRI to evaluate bleeding. Minerva Med 106:117–120

    CAS  PubMed  Google Scholar 

  42. Liu X, Ekholm S, Tian W, et al (2006) Preliminary application study of MR perfusion imaging and diffusion tensor imaging in tumor like lesions in the cervical spinal cord. In: Proceedings 14th scientific meeting international society for magnetic resonance in medicine, p 985

  43. Moukaddam H, Pollak J, Haims AH (2009) MRI characteristics and classification of peripheral vascular malformations and tumors. Skelet Radiol 38:535–547. https://doi.org/10.1007/s00256-008-0609-2

    Article  Google Scholar 

  44. Fayad L, Deshmukh S, Subhawong T, Carrino J (2014) Role of MR spectroscopy in musculoskeletal imaging. Indian J Radiol Imaging 24:210. https://doi.org/10.4103/0971-3026.137024

    Article  PubMed  PubMed Central  Google Scholar 

  45. Thawait GK, Subhawong TK, Tatizawa Shiga NY, Fayad LM (2014) “Cystic”-appearing soft tissue masses: what is the role of anatomic, functional, and metabolic MR imaging techniques in their characterization? J Magn Reson Imaging 39:504–511. https://doi.org/10.1002/jmri.24314

    Article  PubMed  Google Scholar 

  46. Kasprian G, Amann G, Panotopoulos J et al (2015) Peripheral nerve tractography in soft tissue tumors: a preliminary 3-tesla diffusion tensor magnetic resonance imaging study. Muscle Nerve 51:338–345. https://doi.org/10.1002/mus.24313

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L’Aquila, Vetoio Street, 1, 67100, L’Aquila, Italy

    Federico Bruno, Francesco Arrigoni, Silvia Mariani, Alessandra Splendiani, Ernesto Di Cesare, Carlo Masciocchi & Antonio Barile

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  1. Federico Bruno
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  2. Francesco Arrigoni
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  3. Silvia Mariani
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Correspondence to Antonio Barile.

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Bruno, F., Arrigoni, F., Mariani, S. et al. Advanced magnetic resonance imaging (MRI) of soft tissue tumors: techniques and applications. Radiol med 124, 243–252 (2019). https://doi.org/10.1007/s11547-019-01035-7

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