MRI surveillance for local recurrence in extremity soft tissue sarcoma

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• The role of magnetic resonance imaging (MRI) in surveillance for local recurrence (LR) in extremity soft tissue sarcoma (STS) is not well-established.
• Early detection of LR is crucial for optimizing oncologic outcomes in STS patients.

Purpose of the Study:

• To evaluate the utility of MRI in detecting LR in extremity STS.
• To characterize the features of LRs identified by MRI.
• To determine if MRI surveillance impacts oncologic outcomes.

Main Methods:

• A retrospective review of 477 patients with extremity STS who underwent surveillance for LR after surgery.
• Comparison of surveillance outcomes between patients who received routine MRI (n=325) and those who received other imaging modalities (n=152).

Main Results:

• MRI detected clinically undetectable LRs in 10.5% of patients in the MRI surveillance cohort.
• MRI was more effective in detecting LRs in high-risk patients, smaller tumors, LRs without mass formation, and those located in the thigh or buttock.
• Patients with MRI-detected LRs showed a trend towards better post-recurrence survival.

Conclusions:

• Routine MRI surveillance is valuable for detecting clinically undetectable LRs in extremity STS.
• MRI is particularly effective for identifying specific types of LRs, including small, mass-less, or thigh/buttock-located recurrences.
• MRI surveillance may be associated with improved oncologic outcomes in extremity STS.