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MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign
R Bhargava1, D M Parham, O E Lasater
1Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 N. Lauderdale St., Memphis, TN 38101, USA.
Background:
T2-weighted MR imaging of soft tissue tumors of neural origin may show round lesions with a central hypointensity and a hyperintense rim resembling a target. We define the "target sign" as a mass consisting of a solitary target, or a multicompartmental mass in which the largest component consists of multiple targets.
Objective:
The objective of this study was to determine whether the target sign can differentiate benign neurofibromas and their malignant counterparts, malignant peripheral nerve sheath tumors. Materials and methods. Preoperative T2-weighted MR images of 23 neurofibromas or malignant peripheral nerve sheath tumors were retrospectively reviewed in 16 patients, aged 3 weeks to 20 years (median 15 years), without knowledge of the pathologic diagnosis. The presence or absence of a target sign was noted.
Results:
The target sign was seen in all 12 neurofibromas and 1 of the 11 malignant peripheral nerve sheath tumors. Statistical analysis showed good differentiation of benign and malignant tumors using this sign (chi = 0.91).
Conclusion:
The target sign on T2-weighted MR imaging is helpful in differentiating neurofibromas from malignant peripheral nerve sheath tumors.
Insights
The target sign on T2-weighted MRI helps distinguish between benign neurofibromas and malignant peripheral nerve sheath tumors. This imaging feature is a valuable tool for diagnosing neural soft tissue tumors.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- T2-weighted MR imaging can reveal a
- target sign
- in neural soft tissue tumors, characterized by a central hypointense area and a hyperintense rim.
- This sign can manifest as a solitary lesion or within a multicompartmental mass.
Purpose of the Study:
- To evaluate the efficacy of the target sign in differentiating benign neurofibromas from malignant peripheral nerve sheath tumors.
- To assess the diagnostic value of the target sign in pediatric and young adult patients.
Main Methods:
- Retrospective review of preoperative T2-weighted MR images from 16 patients (23 tumors).
- Analysis of 23 neurofibromas and malignant peripheral nerve sheath tumors in patients aged 3 weeks to 20 years.
- Assessment of the presence or absence of the target sign, blinded to pathological diagnosis.
Main Results:
- The target sign was observed in all 12 neurofibromas.
- Only 1 out of 11 malignant peripheral nerve sheath tumors exhibited the target sign.
- Statistical analysis indicated significant differentiation between benign and malignant tumors (chi = 0.91).
Conclusions:
- The target sign on T2-weighted MR imaging is a reliable indicator for differentiating neurofibromas from malignant peripheral nerve sheath tumors.
- This imaging finding can aid clinicians in the accurate diagnosis and management of neural soft tissue tumors.