Value of magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) in predicting grade of soft tissue sarcoma

Document Type : Original Article

Authors

1 Department od Radiodiagnosis, Zagazig University, Zagazig, Egypt

2 radiodiagnosis,faculty of medicine,zagazig university,egypt

3 Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt

Abstract

Objectives: To identify the predictive values of MRI features and apparent diffusion coefficient (ADC) measurements that can be used to discriminate high-grade from low grade soft-tissue sarcoma (STS). Patients and methods: In this retrospective research, patients with different histologic grades of STS diagnosed between 2018 and 2020 who had undergone MRI examination and DWI before neo-adjuvant treatment or surgery were included. STS grades (grades 1–3) were recorded from the pathologic specimens and images were evaluated for tumour location, depth, size and characteristic MRI features discriminating low-grade lesions (grade 1 and 2) from high-grade ones (grades 3). Results: Fifty two patients; 29 (55.7%) men and 23 (44.3 %) women with STS, 24 patients with low-grade and 28 patients with high-grade were included. The commonest pathologic type was undifferentiated pleomorphic sarcoma (n = 14), with the majority of tumors 32/52 (61.5%) were in lower extremities. There were three main MRI findings related more to high grade STS: Presence of area compatible with necrosis, tumor margins < 50 % definition and peri-tumoral enhancement, in addition to the ADC mean which was significantly lower in high-grade (0.921±0.308) than in low-grades tumors (1.24±0.414); (p = 0.0006). Conclusion: Our research appraises the conventional MRI findings of tumor margin definitions, amount of necrosis, and peri-tumoral enhancement in addition to ADC measurements in grading of STS with significant reliability to offer predictive data and support clinical decision making.

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