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Osseous invasion by soft-tissue sarcoma: assessment with MR imaging
David A Elias1, Lawrence M White, David J Simpson
1Departments of Diagnostic Imaging, Pathology and Laboratory Medicine, Mount Sinai Hospital and the University Health Network, University of Toronto, 600 University Ave, Toronto, Ontario, Canada M5G 1X5.
Radiology
|October 2, 2003
Summary
Magnetic resonance (MR) imaging effectively detects bone invasion by soft-tissue sarcoma. Key signs like cortical destruction and signal changes on T1- and T2-weighted images show high accuracy, aiding in diagnosis.
Area of Science:
- Radiology
- Oncology
- Orthopedic Surgery
Background:
- Soft-tissue sarcomas can invade adjacent bone.
- Accurate detection of osseous invasion is crucial for treatment planning and prognosis.
- Magnetic resonance (MR) imaging is a primary modality for evaluating soft-tissue tumors.
Purpose of the Study:
- To evaluate the accuracy of MR imaging in detecting osseous invasion by soft-tissue sarcoma.
- To identify specific MR imaging signs indicative of bone involvement.
- To correlate MR findings with histopathologic results.
Main Methods:
- Retrospective analysis of preoperative MR images (1.5 T, T1/T2 weighted) from 51 patients with soft-tissue sarcoma.
- Two blinded readers assessed MR signs of osseous invasion, including abutment, cortical destruction, and signal intensity changes.
- Histopathologic findings served as the reference standard.
Main Results:
- MR imaging demonstrated 100% sensitivity and 93% specificity for detecting osseous invasion.
- Cortical destruction and signal intensity changes (T1/T2 weighted) were highly sensitive (100%) and specific (94-98%) indicators.
- Overall accuracy for MR imaging was 100% sensitivity, 93% specificity, 79% PPV, and 100% NPV.
Conclusions:
- MR imaging findings, including cortical destruction and signal intensity alterations, are reliable indicators of osseous invasion by soft-tissue sarcoma.
- T1- and T2-weighted MR sequences provide valuable information for assessing bone involvement.
- MR imaging is a highly accurate tool for the preoperative evaluation of osseous invasion in soft-tissue sarcoma.