MRI of soft tissue tumours: a structured "8S framework" aligned with WHO 2020 classification

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Soft tissue tumours (STTs) present diagnostic challenges due to varied presentations and overlapping imaging features.
• Magnetic resonance imaging (MRI) provides detailed soft tissue characterization but requires enhanced interpretation for precise diagnosis and risk stratification.

Purpose of the Study:

• To present a novel 8S framework integrating MRI morphology, function, and biological aggressiveness for enhanced STT diagnostic precision and risk stratification.
• To align the 8S framework with the 2020 WHO soft tissue tumour classification for improved clinical decision-making.

Main Methods:

• The 8S framework systematically evaluates eight key MRI features: Site, Size, Shape/Surface, Signal, Surroundings, Sequence behaviour, Surgical assistance, and Satellites/Skips.
• Integration of dynamic contrast enhancement, diffusion characteristics, and invasion patterns to assess biological aggressiveness and metastatic potential.

Main Results:

• The 8S framework offers a clinically actionable MRI strategy for evaluating STTs.
• This integrated approach facilitates differentiation between benign, locally aggressive, and high-grade malignant tumours.

Conclusions:

• The 8S framework, aligned with the 2020 WHO classification, improves diagnostic accuracy and risk stratification for soft tissue tumours.
• This MRI strategy aids in guiding biopsy, surgical planning, and prognosis for patients with STTs.