Radiologic Approach to Soft Tissue Sarcomas

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Bone and Soft Tissue Oncology".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 2127

Special Issue Editors


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Guest Editor
Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria
Interests: tumour diagnostics; sonography; interventional radiology; peripheral nerves

E-Mail Website
Guest Editor
Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria
Interests: sonography; peripheral nerves; musculoskeletal radiology

Special Issue Information

Dear Colleagues,

Soft tissue masses are frequent, as most of them are benign tumours or pseudotumours, and malignant forms are rare. In adults, approximately 1% of malignent neoplasms are soft tissue masses, and approximately 15% in children.. The ratio of benign to malignant soft tissue masses is approximately 100:1.

However, the field of soft tissue sarcomas is challenging, as these rare neoplasms must be diagnosed when small and should be addressed quickly and correctly to achieve the best outcome: classification and grading, as well as staging, are often demanding, and various diagnostic modalities are needed for a straightforward diagnosis. In this context, a multi-faceted approach is usually employed, including radiography, which admittedly plays an subordinate role, magnetic resonance imaging (MRI), and ultrasound (US).

MRI has become the factual main player: impressive images highlight tumours in high contrast and help classify sarcomas according to their size, configuration, and position. For the diagnosis and first assessments of soft tissue sarcomas, sonography has become an indispensable teammate: up-to-date technology and high-frequency probes provide unrivaled, real-time resolution of MSK structures, providing submillimeter-texture depictions that are advantageous for further triage. Additionally, sonography may depict “pathologic” inner vascularity using new Duplex modes or contrast enhancement. An often needed, precise biopsy of a MSK-mass is also within the range of this almost ubiquitous and competitive modality.

So, what is an optimal multimodal approach for diagnosing sarcomas? What is the best modality, or is there even any as standard? How should we assess MSK masses, and which features count?

This Special Issue will provide an overview of the aforementioned topics in the hope that this will help medical practitioners manage patients with potential soft tissue sarcoma in an up-to-date manner.

Dr. Alexander Loizides
Dr. Hannes Gruber
Guest Editors

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Keywords

  • musculoskeletal masses
  • soft tissue sarcomas
  • magnetic resonance imaging
  • sonography
  • contrast-enhanced ultrasound
  • diagnostic features

Published Papers (1 paper)

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Research

14 pages, 6114 KiB  
Article
Evaluation of Classic and Quantitative Imaging Features in the Differentiation of Benign and Atypical Lipomatous Soft Tissue Tumors Using a Standardized Multiparametric MRI Protocol: A Prospective Single-Centre Study in 45 Patients
by Leonhard Gruber, Christian Kremser, Bettina Zelger, Anton Schwabegger, Ena Josip, Dietmar Dammerer, Martin Thaler and Benjamin Henninger
Curr. Oncol. 2023, 30(3), 3315-3328; https://doi.org/10.3390/curroncol30030252 - 13 Mar 2023
Cited by 1 | Viewed by 1641
Abstract
Background: Discrimination between benign and atypical lipomatous tumors (ALT) is important due to potential local complications and recurrence of ALT but can be difficult due to the often-similar imaging appearance. Using a standardized MRI protocol, this study aimed to rank established and quantitative [...] Read more.
Background: Discrimination between benign and atypical lipomatous tumors (ALT) is important due to potential local complications and recurrence of ALT but can be difficult due to the often-similar imaging appearance. Using a standardized MRI protocol, this study aimed to rank established and quantitative MRI features by diagnostic value in the differentiation of benign and atypical lipomatous tumors and to develop a robust scoring system. Methods: Patients with clinical or sonographic suspicion of a lipomatous tumor were prospectively and consecutively enrolled from 2015 to 2019 after ethic review board approval. Histology was confirmed for all ALT and 85% of the benign cases. Twenty-one demographic and morphologic and twenty-three quantitative features were extracted from a standardized MRI protocol (T1/T2-proton-density-weighting, turbo-inversion recovery magnitude, T2* multi-echo gradient-echo imaging, qDIXON-Vibe fat-quantification, T1 relaxometry, T1 mapping, diffusion-weighted and post-contrast sequences). A ranking of these features was generated through a Bayes network analysis with gain-ratio feature evaluation. Results: Forty-five patients were included in the analysis (mean age, 61.2 ± 14.2 years, 27 women [60.0%]). The highest-ranked ALT predictors were septation thickness (gain ratio merit [GRM] 0.623 ± 0.025, p = 0.0055), intra- and peritumoral STIR signal discrepancy (GRM 0.458 ± 0.046, p < 0.0001), orthogonal diameter (GRM 0.554 ± 0.188, p = 0.0013), contrast enhancement (GRM 0.235 ± 0.015, p = 0.0010) and maximum diameter (GRM 0.221 ± 0.075, p = 0.0009). The quantitative features did not provide a significant discriminatory value. The highest-ranked predictors were used to generate a five-tiered score for the identification of ALTs (correct classification rate 95.7% at a cut-off of three positive items, sensitivity 100.0%, specificity 94.9%, likelihood ratio 19.5). Conclusions: Several single MRI features have a substantial diagnostic value in the identification of ALT, yet a multiparametric approach by a simple combination algorithm may support radiologists in the identification of lipomatous tumors in need for further histological assessment. Full article
(This article belongs to the Special Issue Radiologic Approach to Soft Tissue Sarcomas)
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