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Soft-tissue fat tumours: differentiating malignant from benign using proton density fat fraction quantification MRI.

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|April 20, 2019
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Quantifying proton density fat fraction (PDFF) aids in distinguishing liposarcomas from lipomas and atypical lipomatous tumors (ALT). However, differentiating ALT from non-classical lipomas using PDFF, fatty acid composition, or texture analysis remains challenging.

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Lipomas, atypical lipomatous tumors (ALT), and liposarcomas are soft tissue tumors with overlapping imaging features.
  • Accurate differentiation is crucial for appropriate clinical management and treatment planning.

Purpose of the Study:

  • To assess the utility of proton density fat fraction (PDFF) in differentiating lipoma, ALT, and liposarcoma.
  • To explore the use of magnetic resonance imaging (MRI)-based fatty acid composition (FAC) and 3D texture analysis for distinguishing ALT from non-classical lipomas.

Main Methods:

  • Prospective study involving 41 patients (20 women, 21 men) with lipomas, ALTs, and myxoid liposarcomas.
  • Quantitative MRI techniques including spoiled gradient multi-echo imaging for PDFF and FAC analysis.
  • Support vector machine algorithm and 3D texture analysis were employed for differentiation.

Main Results:

  • Significant differences in mean PDFF were observed between liposarcomas and both ALT and lipomas (p=0.0001).
  • PDFF also showed a significant difference between ALT and lipomas (p=0.021), with optimal thresholds identified.
  • Texture analysis failed to differentiate ALT from non-classical lipomas, but FAC unsaturation degree showed a significant difference (p=0.013).

Conclusions:

  • PDFF measurement is a valuable adjunct to standard MRI for differentiating liposarcomas from lipomas and ALTs.
  • Current PDFF, FAC, and texture analysis methods are insufficient to confidently distinguish between ALT and lipomas not solely composed of fat.