What morphological MRI features enable differentiation of low-grade from high-grade soft tissue sarcoma?

BJR open Pub Date : 2022-06-22 eCollection Date: 2022-01-01 DOI:10.1259/bjro.20210081
Sana Boudabbous, Marion Hamard, Essia Saiji, Karel Gorican, Pierre-Alexandre Poletti, Minerva Becker, Angeliki Neroladaki
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引用次数: 4

Abstract

Objective: To assess the diagnostic performance of morphological MRI features separately and in combination for distinguishing low- from high-grade soft tissue sarcoma (STS).

Methods and materials: We retrospectively analysed pre-treatment MRI examinations with T1, T2 with and without fat suppression (FS) and contrast-enhanced T1 obtained in 64 patients with STS categorized histologically as low (n = 21) versus high grade (n = 43). Two musculoskeletal radiologists blinded to histology evaluated MRI features. Diagnostic performance was calculated for each reader and for MRI features showing significant association with histology (p < 0.05). Logistic regression analysis was performed to develop a diagnostic model to identify high-grade STS.

Results: Among all evaluated MRI features, only six features had adequate interobserver reproducibility (kappa>0.5). Multivariate logistic regression analysis revealed a significant association with tumour grade for lesion heterogeneity on FS images, intratumoural enhancement≥51% of tumour volume and peritumoural enhancement for both readers (p < 0.05). For both readers, the presence of each of the three features yielded odds ratios for high grade versus low grade from 4.4 to 9.1 (p < 0.05). The sum of the positive features for each reader independent of reader expertise yielded areas under the curve (AUCs) > 0.8. The presence of ≥2 positive features indicated a high risk for high-grade sarcoma, whereas ≤1 positive feature indicated a low-to-moderate risk.

Conclusion: A diagnostic MRI score based on tumour heterogeneity, intratumoural and peritumoural enhancement enables identification of lesions that are likely to be high-grade as opposed to low-grade STS.

Advances in knowledge: Tumour heterogeneity in Fat Suppression sequence, intratumoural and peritumoural enhancement is identified as signs of high-grade sarcoma.

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哪些MRI形态学特征可以区分低级别和高级别软组织肉瘤?
目的:评价MRI形态学特征单独及综合诊断低级别和高级别软组织肉瘤(STS)的价值。方法和材料:我们回顾性分析了64例组织学上分为低级别(n = 21)和高级别(n = 43)的STS患者治疗前T1、T2伴和不伴脂肪抑制(FS)和对比增强T1的MRI检查结果。两名不了解组织学的肌肉骨骼放射科医生评估了MRI特征。计算每个阅读器的诊断性能以及与组织学有显著相关性的MRI特征(p < 0.05)。采用Logistic回归分析建立诊断模型,以确定高级别STS。结果:在所有评估的MRI特征中,只有6个特征具有足够的观察者间再现性(kappa>0.5)。多因素logistic回归分析显示,FS图像上病变异质性与肿瘤分级、肿瘤内增强≥肿瘤体积的51%和肿瘤周围增强均有显著相关性(p < 0.05)。对于这两位读者来说,这三个特征的存在产生了高分级与低分级的比值比,从4.4到9.1 (p < 0.05)。与读者专业知识无关的每位读者的积极特征之和产生的曲线下面积(aus) > 0.8。≥2个阳性特征提示发生高级别肉瘤的风险,而≤1个阳性特征提示发生中低级别肉瘤的风险。结论:基于肿瘤异质性、肿瘤内和肿瘤周围增强的诊断性MRI评分能够识别可能是高级别而不是低级别STS的病变。知识进展:脂肪抑制序列、肿瘤内和肿瘤周围增强的肿瘤异质性被确定为高级别肉瘤的标志。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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