Skip to main content
Top
Published in: Skeletal Radiology 4/2024

27-09-2023 | Soft Tissue Sarcoma | Scientific Article

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

Authors: Makoto Emori, Hiroyuki Tsuchie, Hiroyuki Takashima, Atsushi Teramoto, Yasutaka Murahashi, Yoshinori Imura, Hidetatsu Outani, Sho Nakai, Satoshi Takenaka, Ryosuke Hirota, Naoya Nakahashi, Junya Shimizu, Kazuyuki Murase, Akira Takasawa, Hiroyuki Nagasawa, Shintaro Sugita, Kohichi Takada, Tadashi Hasegawa, Seiji Okada, Naohisa Miyakoshi, Toshihiko Yamashita

Published in: Skeletal Radiology | Issue 4/2024

Login to get access

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.
Literature
1.
go back to reference Ng VY, Scharschmidt TJ, Mayerson JL, Fisher JL. Incidence and survival in sarcoma in the United States: a focus on musculoskeletal lesions. Anticancer Res. 2013;33(6):2597–604.PubMed Ng VY, Scharschmidt TJ, Mayerson JL, Fisher JL. Incidence and survival in sarcoma in the United States: a focus on musculoskeletal lesions. Anticancer Res. 2013;33(6):2597–604.PubMed
2.
go back to reference Cai Z, Tang X, Liang H, Yang R, Yan T, Guo W. Prognosis and risk factors for malignant peripheral nerve sheath tumor: a systematic review and meta-analysis. World J Surg Oncol. 2020;18(1):257.CrossRefPubMedPubMedCentral Cai Z, Tang X, Liang H, Yang R, Yan T, Guo W. Prognosis and risk factors for malignant peripheral nerve sheath tumor: a systematic review and meta-analysis. World J Surg Oncol. 2020;18(1):257.CrossRefPubMedPubMedCentral
3.
go back to reference Stucky CC, Johnson KN, Gray RJ, Pockaj BA, Ocal IT, Rose PS, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic experience. Ann Surg Oncol. 2012;19(3):878–85.CrossRefPubMed Stucky CC, Johnson KN, Gray RJ, Pockaj BA, Ocal IT, Rose PS, et al. Malignant peripheral nerve sheath tumors (MPNST): the Mayo Clinic experience. Ann Surg Oncol. 2012;19(3):878–85.CrossRefPubMed
4.
go back to reference Roberts CC, Kransdorf MJ, Beaman FD, Adler RS, Amini B, Appel M, et al. ACR appropriateness criteria follow-up of malignant or aggressive musculoskeletal tumors. J Am Coll Radiol. 2016;13(4):389–400.CrossRefPubMed Roberts CC, Kransdorf MJ, Beaman FD, Adler RS, Amini B, Appel M, et al. ACR appropriateness criteria follow-up of malignant or aggressive musculoskeletal tumors. J Am Coll Radiol. 2016;13(4):389–400.CrossRefPubMed
5.
go back to reference Zhao F, Ahlawat S, Farahani SJ, Weber KL, Montgomery EA, Carrino JA, et al. Can MR imaging be used to predict tumor grade in soft-tissue sarcoma? Radiology. 2014;272(1):192–201.CrossRefPubMed Zhao F, Ahlawat S, Farahani SJ, Weber KL, Montgomery EA, Carrino JA, et al. Can MR imaging be used to predict tumor grade in soft-tissue sarcoma? Radiology. 2014;272(1):192–201.CrossRefPubMed
6.
go back to reference Crombé A, Marcellin PJ, Buy X, Stoeckle E, Brouste V, Italiano A, et al. Soft-tissue sarcomas: assessment of MRI features correlating with histologic grade and patient outcome. Radiology. 2019;291(3):710–21.CrossRefPubMed Crombé A, Marcellin PJ, Buy X, Stoeckle E, Brouste V, Italiano A, et al. Soft-tissue sarcomas: assessment of MRI features correlating with histologic grade and patient outcome. Radiology. 2019;291(3):710–21.CrossRefPubMed
7.
go back to reference Li X, Wang Q, Dou Y, Zhang Y, Tao J, Yang L, et al. Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade? Skeletal Radiol. 2020;49(11):1829–38.CrossRefPubMed Li X, Wang Q, Dou Y, Zhang Y, Tao J, Yang L, et al. Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade? Skeletal Radiol. 2020;49(11):1829–38.CrossRefPubMed
8.
go back to reference Lee JH, Kim YR, Lee GM, Ryu JH, Cho EY, Lee YH, et al. Coefficient of variation on Gd-EOB MR imaging: correlation with the presence of early-stage hepatocellular carcinoma in patients with chronic hepatitis B. Eur J Radiol. 2018;102:95–101.CrossRefPubMed Lee JH, Kim YR, Lee GM, Ryu JH, Cho EY, Lee YH, et al. Coefficient of variation on Gd-EOB MR imaging: correlation with the presence of early-stage hepatocellular carcinoma in patients with chronic hepatitis B. Eur J Radiol. 2018;102:95–101.CrossRefPubMed
9.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
10.
go back to reference Zou C, Smith KD, Liu J, Lahat G, Myers S, Wang WL, et al. Clinical, pathological, and molecular variables predictive of malignant peripheral nerve sheath tumor outcome. Ann Surg. 2009;249(6):1014–22.CrossRefPubMed Zou C, Smith KD, Liu J, Lahat G, Myers S, Wang WL, et al. Clinical, pathological, and molecular variables predictive of malignant peripheral nerve sheath tumor outcome. Ann Surg. 2009;249(6):1014–22.CrossRefPubMed
11.
go back to reference Carli M, Ferrari A, Mattke A, Zanetti I, Casanova M, Bisogno G, et al. Pediatric malignant peripheral nerve sheath tumor: the Italian and German soft tissue sarcoma cooperative group. J Clin Oncol: Off J Am Soc Clin Oncol. 2005;23(33):8422–30.CrossRef Carli M, Ferrari A, Mattke A, Zanetti I, Casanova M, Bisogno G, et al. Pediatric malignant peripheral nerve sheath tumor: the Italian and German soft tissue sarcoma cooperative group. J Clin Oncol: Off J Am Soc Clin Oncol. 2005;23(33):8422–30.CrossRef
12.
go back to reference Martin E, Coert JH, Flucke UE, Slooff WM, Ho VKY, van der Graaf WT, et al. A nationwide cohort study on treatment and survival in patients with malignant peripheral nerve sheath tumours. Eur J Cancer (Oxford, England: 1990). 2020;124:77–87.CrossRef Martin E, Coert JH, Flucke UE, Slooff WM, Ho VKY, van der Graaf WT, et al. A nationwide cohort study on treatment and survival in patients with malignant peripheral nerve sheath tumours. Eur J Cancer (Oxford, England: 1990). 2020;124:77–87.CrossRef
13.
go back to reference Imura Y, Outani H, Takenaka S, Yasuda N, Nakai S, Nakai T, et al. Clinical outcomes and prognostic factors for patients with malignant peripheral nerve sheath tumour. Sarcoma. 2021;2021:8335290.CrossRefPubMedPubMedCentral Imura Y, Outani H, Takenaka S, Yasuda N, Nakai S, Nakai T, et al. Clinical outcomes and prognostic factors for patients with malignant peripheral nerve sheath tumour. Sarcoma. 2021;2021:8335290.CrossRefPubMedPubMedCentral
14.
go back to reference LaFemina J, Qin LX, Moraco NH, Antonescu CR, Fields RC, Crago AM, et al. Oncologic outcomes of sporadic, neurofibromatosis-associated, and radiation-induced malignant peripheral nerve sheath tumors. Ann Surg Oncol. 2013;20(1):66–72.CrossRefPubMed LaFemina J, Qin LX, Moraco NH, Antonescu CR, Fields RC, Crago AM, et al. Oncologic outcomes of sporadic, neurofibromatosis-associated, and radiation-induced malignant peripheral nerve sheath tumors. Ann Surg Oncol. 2013;20(1):66–72.CrossRefPubMed
15.
go back to reference van Noesel MM, Orbach D, Brennan B, Kelsey A, Zanetti I, de Salvo GL, et al. Outcome and prognostic factors in pediatric malignant peripheral nerve sheath tumors: an analysis of the European Pediatric Soft Tissue Sarcoma Group (EpSSG) NRSTS-2005 prospective study. Pediatr Blood Cancer. 2019;66(10):e27833.CrossRefPubMed van Noesel MM, Orbach D, Brennan B, Kelsey A, Zanetti I, de Salvo GL, et al. Outcome and prognostic factors in pediatric malignant peripheral nerve sheath tumors: an analysis of the European Pediatric Soft Tissue Sarcoma Group (EpSSG) NRSTS-2005 prospective study. Pediatr Blood Cancer. 2019;66(10):e27833.CrossRefPubMed
16.
go back to reference Anghileri M, Miceli R, Fiore M, Mariani L, Ferrari A, Mussi C, et al. Malignant peripheral nerve sheath tumors: prognostic factors and survival in a series of patients treated at a single institution. Cancer. 2006;107(5):1065–74.CrossRefPubMed Anghileri M, Miceli R, Fiore M, Mariani L, Ferrari A, Mussi C, et al. Malignant peripheral nerve sheath tumors: prognostic factors and survival in a series of patients treated at a single institution. Cancer. 2006;107(5):1065–74.CrossRefPubMed
17.
go back to reference Chhabra A, Ashikyan O, Slepicka C, Dettori N, Hwang H, Callan A, et al. Conventional MR and diffusion-weighted imaging of musculoskeletal soft tissue malignancy: correlation with histologic grading. Eur Radiol. 2019;29(8):4485–94.CrossRefPubMed Chhabra A, Ashikyan O, Slepicka C, Dettori N, Hwang H, Callan A, et al. Conventional MR and diffusion-weighted imaging of musculoskeletal soft tissue malignancy: correlation with histologic grading. Eur Radiol. 2019;29(8):4485–94.CrossRefPubMed
18.
go back to reference Limkin EJ, Sun R, Dercle L, Zacharaki EI, Robert C, Reuzé S, et al. Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology. Ann Oncol: Off J Eur Soc Med Oncol. 2017;28(6):1191–206.CrossRef Limkin EJ, Sun R, Dercle L, Zacharaki EI, Robert C, Reuzé S, et al. Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology. Ann Oncol: Off J Eur Soc Med Oncol. 2017;28(6):1191–206.CrossRef
Metadata
Title
Coefficient of variation of T2-weighted MRI may predict the prognosis of malignant peripheral nerve sheath tumor
Authors
Makoto Emori
Hiroyuki Tsuchie
Hiroyuki Takashima
Atsushi Teramoto
Yasutaka Murahashi
Yoshinori Imura
Hidetatsu Outani
Sho Nakai
Satoshi Takenaka
Ryosuke Hirota
Naoya Nakahashi
Junya Shimizu
Kazuyuki Murase
Akira Takasawa
Hiroyuki Nagasawa
Shintaro Sugita
Kohichi Takada
Tadashi Hasegawa
Seiji Okada
Naohisa Miyakoshi
Toshihiko Yamashita
Publication date
27-09-2023
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 4/2024
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-023-04457-7

Other articles of this Issue 4/2024

Skeletal Radiology 4/2024 Go to the issue