Soft tissue sarcoma: can dynamic contrast-enhanced (DCE) MRI be used to predict the histological grade?

• Published in: Skeletal radiology 2020-11, Vol.49 (11), p.1829-1838
• Main Authors: Li, Xiangwen, Wang, Qimeng, Dou, Yanping, Zhang, Yu, Tao, Juan, Yang, Lin, Wang, Shaowu
• Format: Article
• Language: English
• Subjects: Diagnostic systems; Health aspects; Imaging; Magnetic resonance imaging; Medical materials; Medical records; Medicine; Medicine & Public Health; Necrosis; Nuclear Medicine; Orthopedics; Parameters; Pathology; Radiology; Sarcoma; Scientific Article; Soft tissue sarcoma; Soft tissues; Tumors
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-020-03491-z

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. Semi-quantitative parameters, including iAUC and TTP, and quantitative parameters, including K trans , K ep , and V e , 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 T 2 WI (> 75%), peritumoral hyperintensity on T 2 WI, or tumor necrosis (> 50%) compared with low-grade STS. On DCE-MRI, iAUC, TTP, K trans , and K ep were significant predictors of STS histological grade. K trans had a high diagnostic value for differentiating between high-grade and low-grade STSs. The combination of iAUC, TTP, and K trans 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 (T 2 WI), and extensive necrosis. On DCE-MRI, iAUC, TTP, K trans , and K ep could differentiate between high-grade and low-grade STSs. The combination of iAUC, TTP, and K trans had a high diagnostic performance for differentiating between STS histological grades.