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Do contrast-enhanced and advanced MRI sequences improve diagnostic accuracy for indeterminate lipomatous tumors?
- Source :
-
La Radiologia medica [Radiol Med] 2022 Jan; Vol. 127 (1), pp. 90-99. Date of Electronic Publication: 2021 Oct 25. - Publication Year :
- 2022
-
Abstract
- Purpose: Benign, intermediate-grade and malignant tumors sometimes have overlapping imaging and clinical characteristics. The purpose of this study was to evaluate the added value of contrast-enhanced sequences (dynamic contrast enhancement (DCE)), diffusion-weighted imaging (DWI), and chemical shift imaging (CSI) to noncontrast MRI sequences for the characterization of indeterminate lipomatous tumors.<br />Materials and Methods: Thirty-two consecutive patients with histologically proven peripheral lipomatous tumors were retrospectively evaluated. Two musculoskeletal radiologists recorded the MRI features in three sessions: (1) with noncontrast T1-weighted and fluid-sensitive sequences; (2) with addition of static pre- and post-contrast 3D volumetric T1-weighted sequences; and (3) with addition of DCE, DWI, and CSI. After each session, readers recorded a diagnosis (benign, intermediate/atypical lipomatous tumor (ALT), or malignant/dedifferentiated liposarcoma (DDL)). Categorical imaging features (presence of septations, nodules, contrast enhancement) and quantitative metrics (apparent diffusion coefficient values, CSI signal loss) were recorded.<br />Results: For 32 tumors, the diagnostic accuracy of both readers did not improve with the addition of contrast-enhanced sequences, DWI, or CSI (53% (17/32) session 1; 50% (16/30) session 2; 53% (17/32) session 3). Noncontrast features, including thick septations (p = 0.025) and nodules ≥ 1 cm (p < 0.001), were useful for differentiating benign tumors from ALTs and DDLs, as were DWI (p = 0.01) and CSI (p = 0.009) metrics.<br />Conclusion: The addition of contrast-enhanced sequences (static, DCE), DWI, and CSI to a conventional, noncontrast MRI protocol did not improve diagnostic accuracy for differentiating benign, intermediate-grade, and malignant lipomatous tumors. However, we identified potentially useful imaging features by DCE, DWI, and CSI that may help distinguish these entities.<br /> (© 2021. Italian Society of Medical Radiology.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging
Female
Humans
Male
Middle Aged
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Young Adult
Contrast Media
Image Enhancement methods
Lipoma diagnostic imaging
Liposarcoma diagnostic imaging
Magnetic Resonance Imaging methods
Muscle Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1826-6983
- Volume :
- 127
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- La Radiologia medica
- Publication Type :
- Academic Journal
- Accession number :
- 34697728
- Full Text :
- https://doi.org/10.1007/s11547-021-01420-1