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- Title
Added value of diffusion-weighted imaging to conventional MRI for predicting fascial involvement of soft tissue sarcomas.
- Authors
Yoon, Min A; Chee, Choong Guen; Chung, Hye Won; Song, Joon Seon; Lee, Jong Seok; Kim, Wanlim; Lee, Min Hee; Lee, Sang Hoon; Shin, Myung Jin
- Abstract
<bold>Objectives: </bold>This study was conducted to evaluate the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance imaging (MRI) for predicting fascial involvement of soft tissue sarcomas located in close proximity to fascial boundaries.<bold>Methods: </bold>This retrospective study included 29 patients with surgically resected soft tissue sarcomas located in proximity to deep fascia and with a curvilinear tail-like hyperintensity in the adjacent fascia on T2-weighted images. All patients underwent conventional MRI and DWI at 3.0 T and had detailed histologic reports on involvement of fascia. Two musculoskeletal radiologists with 21 and 1 year of experience independently reviewed conventional MRI and conventional imaging with added DWI. Readers scored their confidence for tumor involvement of fascia using a three-point scale. Diagnostic performance (area under the curve [Az]) of the two MRI sets was assessed with receiver-operating characteristic curve analysis.<bold>Result: </bold>Fascial involvement was present in 22/29 patients (75.9%). Both readers showed improvement in diagnostic performance with the addition of DWI (Az, from 0.545 to 0.792 and from 0.646 to 0.792 for reader 1 and reader 2, respectively). Adding DWI did not improve sensitivity or specificity for either reader (p > 0.05). Interobserver agreement for the confidence scores improved from fair to moderate with the addition of DWI (κ, from 0.390 to 0.560).<bold>Conclusions: </bold>Adding DWI to conventional MRI improved diagnostic performance on prediction of fascial involvement of soft tissue sarcomas located in proximity to fascia, without significant improvement in sensitivity or specificity.<bold>Key Points: </bold>• Adding DWI to conventional MRI improved readers' confidence level for the prediction of fascial involvement of soft tissue sarcomas that are close to the deep fascia. • Addition of DWI also improved interobserver agreement. • Conversely, compared with conventional MRI, adding DWI did not significantly improve the sensitivity or specificity for the detection of fascial involvement.
- Subjects
SARCOMA; DIFFUSION magnetic resonance imaging; FASCIAE (Anatomy); MAGNETIC resonance imaging; SOFT tissue tumors; CONTRAST media; RETROSPECTIVE studies; RECEIVER operating characteristic curves
- Publication
European Radiology, 2019, Vol 29, Issue 4, p1863
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5786-3