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01-08-2019 | Musculoskeletal

Conventional MR and diffusion-weighted imaging of musculoskeletal soft tissue malignancy: correlation with histologic grading

Authors: Avneesh Chhabra, Oganes Ashikyan, Chenelle Slepicka, Nathan Dettori, Helena Hwang, Alexandra Callan, Rohit R. Sharma, Yin Xi

Published in: European Radiology | Issue 8/2019

Abstract

Aim

To evaluate proven soft tissue musculoskeletal malignancies blinded to their Fédération Nationale des Centres de Lutte Contre le Cancer histologic grades to identify the predictive values of conventional MR findings and best fit region of interest (ROI) apparent diffusion coefficient (ADC) measurements.

Materials and methods

Fifty-one consecutive patients with different histologic grades were evaluated by four readers (R1–4) of different experience levels. Quantitatively, the maximum longitudinal size, tumor to muscle signal intensity ratios, and ADC measurements and, qualitatively, the spatial location of the tumor, its signal alterations, heterogeneity, intralesional hemorrhage or fat, and types of enhancement were assessed. Intraclass correlation, weighted kappa, ANOVA, and Fisher exact tests were used.

Results

There were 22/51 (43%) men (mean age ± SD = 52 ± 16 years) and 29/51 (57%) women (mean age ± SD = 54± 17 years), with the majority of tumors 38/51 (75%) in the lower extremities. Histologic grades were I in 8/51 (16%), II in 17/51 (33%), and III in 26/51 (51%), respectively. The longitudinal dimensions were different among three grades (p = 0.0015), largest with grade I. More central enhancements and deep locations were seen in grade III tumors (p = 0.0191, 0.0246). The ADC mean was significantly lower in grade III than in grade I or II (p < 0.0001 and p = 0.04). The ADC min was significantly lower in grade III than in grade I (p = 0.02). Good to excellent agreements were seen for T1/T2 tumor/muscle ratios, longitudinal dimension, and ADC (ICC = 0.60–0.98).

Conclusion

Longitudinal tumor dimension, central enhancement, and ADC values differentiate histology grades in musculoskeletal soft tissue malignancy with good to excellent inter-reader reliability.

Key Points

• The longitudinal tumor dimension of grade III malignancy is smaller than that of grade I (p < 0.0001), and higher-grade tumors are located deeper (p = 0.0246).

• The ADC mean is significantly lower in grade III than in grade I or grade II (p < 0.0001 and p = 0.04).

• The ADC minimum is significantly lower in grade III than in grade I (p = 0.02).

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Title: Conventional MR and diffusion-weighted imaging of musculoskeletal soft tissue malignancy: correlation with histologic grading
Authors: Avneesh Chhabra
Oganes Ashikyan
Chenelle Slepicka
Nathan Dettori
Helena Hwang
Alexandra Callan
Rohit R. Sharma
Yin Xi
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5845-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Conventional MR and diffusion-weighted imaging of musculoskeletal soft tissue malignancy: correlation with histologic grading

Abstract

Aim

Materials and methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Materials and methods

Results

Conclusion

Key Points

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