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European Radiology
Published in: European Radiology 12/2016

01-12-2016 | Musculoskeletal

Does size reliably predict malignancy in soft tissue tumours?

Authors: Leonhard Gruber, Alexander Loizides, Laurin Ostermann, Bernhard Glodny, Michaela Plaikner, Hannes Gruber

Published in: European Radiology | Issue 12/2016

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Abstract

Purpose

In this retrospective study we examined whether size is a viable marker of tumour malignancy in soft tissue masses (STM) and if the ratio of width and length (RALD) of an STM reflects tumour biology more accurately.

Methods

Measurements of maximal lesion size and perpendicular diameter were performed in available MRI and ultrasonography studies of 212 patients (mean age 54.4 ± 17.2 years, male:female 1:1.12) with a histologically verified diagnosis.

Results

Overall, 28.2 % of lesions were malignant, 11.1 % intermediate, and 58.8 % benign. Size alone was a weak predictor of malignancy in STMs (sensitivity 68.8 %, specificity 50.3 %, positive predictive value [PPV] 44.0 %, negative predictive value [NPV] 80.4 %). RALD showed better discriminatory power with greater separation between benign and malignant entities and higher values for sensitivity (83.6 %), specificity (53.6 %), and NPV (89.0 %). A weighted combination of size, age and RALD improved diagnostic power, demonstrating higher values for sensitivity (77.0 %), specificity (80.1 %), PPV (61.0 %), and NPV (89.6 %).

Conclusions

Size should not be used alone to estimate an STM’s malignancy. RALD better reflects a lesion’s growth pattern and a combination of age, size, and RALD helps to discriminate more accurately between benign, intermediate, and malignant entities. These findings should help to estimate easily whether a newly found STM is benign or malignant prior to further workup.

Key Points

•Size does not reliably differentiate between benign, intermediate, and malignant tumours
•The R ALD (ratio of lateral to axial diameter) improves diagnostic confidence
•When combined with age and size, STM differentiation was further enhanced
•These measurements can aid in earlier detection of sarcomas
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Metadata
Title
Does size reliably predict malignancy in soft tissue tumours?
Authors
Leonhard Gruber
Alexander Loizides
Laurin Ostermann
Bernhard Glodny
Michaela Plaikner
Hannes Gruber
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4300-z

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