Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade?
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SCIENTIFIC ARTICLE
Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade? Xiangwen Li 1 & Qimeng Wang 1 & Yanping Dou 2 & Yu Zhang 1 & Juan Tao 3 & Lin Yang 1 & Shaowu Wang 1 Received: 1 March 2020 / Revised: 25 May 2020 / Accepted: 25 May 2020 # ISS 2020
Abstract Objective To determine if dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters reflect histological grade of soft tissue sarcoma (STS) Materials and methods The medical records of 50 patients diagnosed with pathologically confirmed STS were retrospectively reviewed. Each STS was assessed with conventional contrast-enhanced MRI and DCE-MRI using a 3.0-T MRI system. The conventional MRI characteristics of low-grade (grade 1) and high-grade (grade 2 and grade 3) tumors were analyzed. Semiquantitative parameters, including iAUC and TTP, and quantitative parameters, including Ktrans, Kep, and Ve, were derived from DCE-MRI. The diagnostic performances and optimal thresholds of various combinations of DCE-MRI parameters for predicting histological grades of STS were investigated using receiver operator characteristic (ROC) curves. Results On conventional MRI, high-grade STSs were significantly larger (≥ 5 cm) and more likely to show a heterogeneous signal intensity on T2WI (> 75%), peritumoral hyperintensity on T2WI, or tumor necrosis (> 50%) compared with low-grade STS. On DCE-MRI, iAUC, TTP, Ktrans, and Kep were significant predictors of STS histological grade. Ktrans had a high diagnostic value for differentiating between high-grade and low-grade STSs. The combination of iAUC, TTP, and Ktrans yielded a higher AUC value (0.841) than the other models. Conclusion High-grade STSs were usually larger than low-grade STSs, had unclear boundaries, a heterogeneous signal intensity on T2-weighted image (T2WI), and extensive necrosis. On DCE-MRI, iAUC, TTP, Ktrans, and Kep could differentiate between high-grade and low-grade STSs. The combination of iAUC, TTP, and Ktrans had a high diagnostic performance for differentiating between STS histological grades. Keywords Soft tissue sarcoma . Dynamic contrast-enhanced (DCE) . MRI . Histological grade
Introduction Soft tissue sarcoma (STS) is a heterogeneous group of rare malignancies that have a high rate of recurrence and mortality. Outcomes in patients with high-grade STS are substantially Xiangwen Li, Qimeng Wang and Yanping Dou contributed equally to this work. * Shaowu Wang [email protected] 1
Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning Province, China
2
Department of Ultrasound, The First Affiliated Hospital, Dalian Medical University, Dalian, China
3
Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, China
improved by treatment with neoadjuvant radiotherapy and/or chemotherapy [1–6]; therefore, histological type and grade are important prognostic factors that guide STS treatment decision-making [7–12]. Currently, preoperative histological grading of STS requires a b
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