MRI features outperform histologic grade for outcome prediction in translocation-driven enriched soft-tissue sarcoma.

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prognostic value of MRI in soft-tissue sarcoma (STS) is uncertain in translocation-driven subtypes.
• Conventional MRI descriptors may not apply to enriched translocation-driven STS populations.

Purpose of the Study:

• Identify preoperative MRI features predicting overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) in translocation-driven STS.
• Assess the prognostic value of MRI in a cohort enriched with translocation-driven STS.

Main Methods:

• Retrospective single-center study of 158 adult STS patients.
• Contrast-enhanced MRI features scored by two blinded radiologists.
• Cox regression analysis adjusted for clinical factors and translocation-driven histology.

Main Results:

• Heterogeneous gadolinium enhancement independently predicted shorter OS (HR, 3.9).
• Peritumoral edema independently predicted shorter OS (HR, 2.0) and LRFS (HR, 2.3).
• These associations remained significant after adjusting for translocation-driven histology; a 13-feature MRI panel did not discriminate high-grade tumors.

Conclusions:

• Peritumoral edema and heterogeneous gadolinium enhancement are independent MRI predictors of outcome in translocation-driven STS.
• These MRI features outperform FNCLCC grade and molecular histology for predicting survival.
• Prospective multicenter validation is needed before clinical application.