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Imaging findings for differentiating and predicting prognosis in undifferentiated pleomorphic sarcoma and
Masaya Kawaguchi1, Hiroki Kato1, Tomohiro Kanayama2
1Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
Objective:
This study aimed to examine the imaging findings of undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) and identify a prognostic factor for recurrence.
Materials And Methods:
The research included 41 individuals who histopathologically and immunohistochemically confirmed UPS and MFS. MFS was histologically distinguished from UPS using the 10% myxoid area as the threshold value. MRI, CT, and 18F-fluorodeoxyglucose-PET/CT results were retrospectively examined and compared between the two diseases.
Results:
The results showed that 18 individuals had UPS, whereas 23 had MFS. The predominant signal intensity on T2-weighted images was low or intermediate in UPS (89 %) but high in MFS (87 %, p < 0.01). The tumor-to-muscle signal intensity ratio on T2-weighted images (2.8 vs. 3.8, p < 0.01) and apparent diffusion coefficient (ADC) values (0.93 vs. 1.52 × 10-3mm2/s, p < 0.01) were lower in UPS than in MFS. CT attenuation (37 vs. 22 Hounsfield Unit, p < 0.01) and maximum standardized uptake value (SUVmax) (15.6 vs. 5.2, p < 0.01) were greater in UPS than in MFS. Univariate analysis found that pathological diagnosis of UPS (hazard ratio: 15.6) and low or intermediate signal intensity on T2-weighted images (hazard ratio: 15.7) were predictors of recurrence.
Conclusion:
The signal intensity on T2-weighted images, ADC value, CT attenuation, and SUVmax were relevant imaging results for distinguishing UPS from MFS. The pathological diagnosis and signal intensity on T2-weighted images were prognostic indicators of recurrence.
