Tags

Type your tag names separated by a space and hit enter

Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T.
Radiology. 2014 May; 271(2):499-511.R

Abstract

PURPOSE

To determine the added value of functional magnetic resonance (MR) sequences (dynamic contrast material-enhanced [DCE] and quantitative diffusion-weighted [DW] imaging with apparent diffusion coefficient [ADC] mapping) for the detection of recurrent soft-tissue sarcomas following surgical resection.

MATERIALS AND METHODS

This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. Thirty-seven patients referred for postoperative surveillance after resection of soft-tissue sarcoma (35 with high-grade sarcoma) were studied. Imaging at 3.0 T included conventional (T1-weighted, fluid-sensitive, and contrast-enhanced T1-weighted imaging) and functional (DCE MR imaging, DW imaging with ADC mapping) sequences. Recurrences were confirmed with biopsy or resection. A disease-free state was determined with at least 6 months of follow-up. Two readers independently recorded the signal and morphologic characteristics with conventional sequences, the presence or absence of arterial enhancement at DCE MR imaging, and ADCs of the surgical bed. The accuracy of conventional MR imaging in the detection of recurrence was compared with that with the addition of functional sequences. The Fisher exact and Wilcoxon rank sum tests were used to define the accuracy of imaging features, the Cohen κ and Lin interclass correlation were used to define interobserver variability, and receiver operating characteristic analysis was used to define a threshold to detect recurrence and assess reader confidence after the addition of functional imaging to conventional sequences.

RESULTS

There were six histologically proved recurrences in 37 patients. Sensitivity and specificity of MR imaging in the detection of tumor recurrence were 100% (six of six patients) and 52% (16 of 31 patients), respectively, with conventional sequences, 100% (six of six patients) and 97% (30 of 31 patients) with the addition of DCE MR imaging, and 60% (three of five patients) and 97% (30 of 31 patients) with the addition of DW imaging and ADC mapping. The average ADC of recurrence (1.08 mm(2)/sec ± 0.19) was significantly different from those of postoperative scarring (0.9 mm(2)/sec ± 0.00) and hematomas (2.34 mm(2)/sec ± 0.72) (P = .03 for both).

CONCLUSION

The addition of functional MR sequences to a routine MR protocol, in particular DCE MR imaging, offers a specificity of more than 95% for distinguishing recurrent sarcoma from postsurgical scarring.

Authors+Show Affiliations

From the Russell H. Morgan Department of Radiology and Radiological Science (F.D.G., T.S., M.A., C.M., L.M.F.) and Department of Orthopaedic Surgery (K.W.), Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24495264

Citation

Del Grande, Filippo, et al. "Detection of Soft-tissue Sarcoma Recurrence: Added Value of Functional MR Imaging Techniques at 3.0 T." Radiology, vol. 271, no. 2, 2014, pp. 499-511.
Del Grande F, Subhawong T, Weber K, et al. Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T. Radiology. 2014;271(2):499-511.
Del Grande, F., Subhawong, T., Weber, K., Aro, M., Mugera, C., & Fayad, L. M. (2014). Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T. Radiology, 271(2), 499-511. https://doi.org/10.1148/radiol.13130844
Del Grande F, et al. Detection of Soft-tissue Sarcoma Recurrence: Added Value of Functional MR Imaging Techniques at 3.0 T. Radiology. 2014;271(2):499-511. PubMed PMID: 24495264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T. AU - Del Grande,Filippo, AU - Subhawong,Ty, AU - Weber,Kristy, AU - Aro,Michael, AU - Mugera,Charles, AU - Fayad,Laura M, Y1 - 2014/02/01/ PY - 2014/2/6/entrez PY - 2014/2/6/pubmed PY - 2014/6/25/medline SP - 499 EP - 511 JF - Radiology JO - Radiology VL - 271 IS - 2 N2 - PURPOSE: To determine the added value of functional magnetic resonance (MR) sequences (dynamic contrast material-enhanced [DCE] and quantitative diffusion-weighted [DW] imaging with apparent diffusion coefficient [ADC] mapping) for the detection of recurrent soft-tissue sarcomas following surgical resection. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. Thirty-seven patients referred for postoperative surveillance after resection of soft-tissue sarcoma (35 with high-grade sarcoma) were studied. Imaging at 3.0 T included conventional (T1-weighted, fluid-sensitive, and contrast-enhanced T1-weighted imaging) and functional (DCE MR imaging, DW imaging with ADC mapping) sequences. Recurrences were confirmed with biopsy or resection. A disease-free state was determined with at least 6 months of follow-up. Two readers independently recorded the signal and morphologic characteristics with conventional sequences, the presence or absence of arterial enhancement at DCE MR imaging, and ADCs of the surgical bed. The accuracy of conventional MR imaging in the detection of recurrence was compared with that with the addition of functional sequences. The Fisher exact and Wilcoxon rank sum tests were used to define the accuracy of imaging features, the Cohen κ and Lin interclass correlation were used to define interobserver variability, and receiver operating characteristic analysis was used to define a threshold to detect recurrence and assess reader confidence after the addition of functional imaging to conventional sequences. RESULTS: There were six histologically proved recurrences in 37 patients. Sensitivity and specificity of MR imaging in the detection of tumor recurrence were 100% (six of six patients) and 52% (16 of 31 patients), respectively, with conventional sequences, 100% (six of six patients) and 97% (30 of 31 patients) with the addition of DCE MR imaging, and 60% (three of five patients) and 97% (30 of 31 patients) with the addition of DW imaging and ADC mapping. The average ADC of recurrence (1.08 mm(2)/sec ± 0.19) was significantly different from those of postoperative scarring (0.9 mm(2)/sec ± 0.00) and hematomas (2.34 mm(2)/sec ± 0.72) (P = .03 for both). CONCLUSION: The addition of functional MR sequences to a routine MR protocol, in particular DCE MR imaging, offers a specificity of more than 95% for distinguishing recurrent sarcoma from postsurgical scarring. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/24495264/Detection_of_soft_tissue_sarcoma_recurrence:_added_value_of_functional_MR_imaging_techniques_at_3_0_T_ L2 - http://pubs.rsna.org/doi/10.1148/radiol.13130844?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -