These data are consistent with the hypothesis that the IPFP is an osteoarthritic joint tissue capable of modulating inflammatory and destructive responses in knee-OA.
Although similar findings were found in some lesions, the large histologic variability of NF hampers the definition of a prototype of NF on MRI. However, the MRI appearance of the myxoid subtype is rather characteristic. Histologic findings reflect the different SI characteristics and enhancement pattern on MRI.
This article outlines the ability of MR imaging in staging, grading, tissue characterization, and posttherapeutic surveillance of soft tissue tumors. Well-known staging parameters, such as extent, relationship with adjacent structures, and detection of intralesional necrosis, are used in the MR protocol for locoregional staging. Bone scintigraphy and high-resolution CT scan of the lungs are best methods for ruling out metastatic spread. A variety of (solitary or combinations of) grading parameters are described in the radiological literature. The role of MR imaging is to afford recognition of these lesions that need further aggressive work-up, excluding all others. Despite controversial reports, the definite role of MR imaging in grading of soft tissue tumors seems to become established. As for grading, a lot of individual imaging characteristics used for tissue characterization have low sensitivity, but combinations of parameters (age, site, signal intensities) are more useful and often allow to predict a specific diagnosis or to narrow down the list of differential diagnoses. Local recurrences of soft tissue tumors are frequent and can be detected accurately by an easy-to-use MR algorithm.
Soft tissue sarcomas are uncommon tumours of mesenchymal origin, most commonly arising in the extremities. Treatment includes surgical resection in combination with radiotherapy. Resection margins are of paramount importance in surgical treatment of soft tissue sarcomas but unambiguous guidelines for ideal margins of resection are still missing as is an uniform guideline on the use of radiotherapy.The present paper reviews the literature on soft tissue sarcomas of the extremities regarding the required resection margins, the impact of new radiotherapy techniques and the timing of radiotherapy, more particularly if it should be administered before or after surgical resection.This review was started by searching guidelines in different databases (National Guideline Clearinghouse, EBMPracticeNet, TRIP database, NCCN guidelines,…). After refinement of the query, more specific articles were found using MEDLINE, PubMed, Web of Science and Google Scholar. Used keywords include “soft tissue sarcoma”; “extremities OR limbs”; “radiotherapy”, “surgery”, “margins”, “local recurrence” and “overall survival”. Finally, the articles were selected based on the accessibility of the full text, use of the English language and relevance based on title and abstract.Literature demonstrates positive resection margins to be an important adverse prognostic factor for local recurrence of soft tissue sarcomas of the extremities. Still, no consensus is reached on the definition of what a good margin might be. The evolution of new radiation techniques, especially Intensity Modulated Radiotherapy, resulted in a s healthy surrounding tissues. However, the timing of radiotherapy treatment remains controversial as both preoperative and postoperative radiotherapy are characterised by several advantages and disadvantages.
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