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Updated: Feb 2, 2026
Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
Published on: April 11, 2018
Soft tissue sarcoma: adding diffusion-weighted imaging improves MR imaging evaluation of tumor margin infiltration
Ji Hyun Hong1,2, Won-Hee Jee3, Chan-Kwon Jung4
1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
Purpose:
To determine the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance (MR) imaging in assessment of tumor margin infiltration in soft tissue sarcoma (STS) at 3T.
Materials And Methods:
The institutional review board approved this retrospective study. Forty-five patients who underwent 3T MR imaging including DWI and were pathologically confirmed were included in this study. Two readers retrospectively scored conventional MR imaging alone. Then, they assessed a combination of conventional MR imaging and DWI. At pathology, margin infiltration was retrospectively reviewed by one pathologist blinded to MR findings. Areas under the curve (AUCs) of the receiver-operating characteristic curve were obtained for diagnostic performance. Interobserver agreement for the scoring of margin infiltration of STS was assessed with kappa statistics.
Results:
Among 45 cases of STS, 33 had infiltrative tumor margin at pathology. Sensitivity, specificity, and accuracy of each reader were 100%, 17%, and 78%; 97%, 25%, and 78% on conventional MR imaging alone and 94%, 67%, and 87%; 94%, 42%, and 80% on conventional MR imaging combined with DWI. AUCs of conventional MR imaging combined with DWI were significantly higher than those of conventional MR imaging alone: 0.890 vs 0.678 (p = .0123) and 0.846 vs 0.640 (p = .0305) for each reader. Interobserver agreements of conventional MR imaging alone and conventional MR imaging combined with DWI were moderate to substantial (κ = 0.646, κ = 0.496).
Conclusion:
The addition of DWI to conventional MR imaging may improve specificity for assessing tumor margin infiltration in STS at 3T.
Key Points:
• DWI has added value for assessment of tumor margin infiltration in soft tissue sarcoma. • Addition of DWI to conventional MRI at 3T may improve specificity. • Addition of DWI to conventional MRI may help orthopedic surgeon determine the extent of the resection margin.
Insights
Adding diffusion-weighted imaging (DWI) to conventional MRI for soft tissue sarcoma (STS) improves tumor margin assessment. This technique enhances specificity, aiding surgeons in determining resection margins.
Area of Science:
- Radiology
- Oncology
- Orthopedic Surgery
Background:
- Soft tissue sarcomas (STS) are malignant tumors requiring precise assessment of tumor margins for effective treatment.
- Conventional magnetic resonance (MR) imaging is standard for evaluating STS, but assessing tumor infiltration can be challenging.
Purpose of the Study:
- To evaluate the added diagnostic value of diffusion-weighted imaging (DWI) to conventional 3 Tesla (3T) MR imaging in determining tumor margin infiltration in STS.
- To compare the diagnostic performance of conventional MR imaging alone versus combined with DWI for STS margin assessment.
Main Methods:
- A retrospective analysis of 45 patients with pathologically confirmed STS who underwent 3T MR imaging, including DWI.
- Two radiologists assessed tumor margin infiltration using conventional MR imaging alone and then with the addition of DWI.
- Diagnostic performance was evaluated using receiver-operating characteristic (ROC) curve analysis, and interobserver agreement was assessed using kappa statistics.
Main Results:
- The combination of conventional MR imaging and DWI showed significantly higher areas under the curve (AUCs) compared to conventional MR imaging alone (0.890 vs. 0.678 and 0.846 vs. 0.640).
- The addition of DWI improved specificity in assessing tumor margin infiltration, with sensitivity, specificity, and accuracy ranging from 94-100%, 42-67%, and 80-87% respectively.
- Interobserver agreement for margin assessment was moderate to substantial with both methods.
Conclusions:
- Diffusion-weighted imaging (DWI) provides added value in assessing tumor margin infiltration in soft tissue sarcoma (STS) at 3T.
- The integration of DWI with conventional MR imaging enhances diagnostic specificity, potentially improving surgical planning for resection margins.
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