Imaging presentation of extraskeletal osteosarcomas on CT and MRI and correlation with patients outcome: A two-center retrospective study of 54 patients

Crombé, Amandine; Spinnato, Paolo; Righi, Alberto; Leopardi, Martina Piccinni; Carpenzano, M.; Izzo, Federica; Parmeggiani, A; Linck, Pierre-Antoine; Perret, Raul; Cesari, Marilena; Longhi, Alessandra; Miceli, Marco; Kind, Michèle; Bianchi, Giuseppe

doi:10.1016/j.diii.2023.01.009

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…In a study of human cases, it was reported that 62% of exOSA tumors were calcified, as follows: mineralization extent <10% of tumor volume in 12/42 patients, 10–50% in 7/42 patients, and >50% in 7/42 patients. Amorphous calcification was the most common pattern (18/26), followed by spindle-shaped (6/26) and dot-shaped (2/26) mineralization [ 25 ]. In comparison, the present study demonstrated a higher prevalence of tumor mineralization.…”

Section: Discussionmentioning

confidence: 99%

“…The images were reviewed using commercially available image viewing software (Radiant; Medixant, Proznan, Poland) by a clinician with 4 years of experience in veterinary diagnostic imaging (JJ) under the supervision of a senior clinician with >10 years of experience in radiology (JK). The following qualitative CT features were assessed: location (subcutaneous, mammary, or visceral), margins (ill-or well-defined), enhancement pattern (homogeneous or heterogeneous, presence or absence of peripheral rim enhancement), mineralization (present or absent), degree of mineralization (mild, moderate, or marked), shape of mineralization (dot, spindle, or amorphous), location of mineralization (concentric, eccentric, or mixed within the tumor), presumptive pulmonary metastasis (present or absent), and lymphadenopathy (present or absent) [25]. Mineralization was assessed using a bone window, whereas other features were evaluated with a soft tissue window, except for the presence of pulmonary metastasis, which was assessed using a lung window.…”

Section: Data Collection Ct Examinations and Image Analysismentioning

confidence: 99%

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Case Series: Computed Tomography Features of Extraskeletal Osteosarcoma in Six Dogs

Jeong,

Kim,

Kim

et al. 2024

Veterinary Sciences

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The objective of the present case series was to investigate the various computed tomography findings of six dogs diagnosed with extraskeletal osteosarcoma (exOSA) at several locations. Among the tumors evaluated, four were subcutaneous, one was mammary, and one involved the intestinal tract. Intralesional mineralization was observed in all six dogs. Most of the tumors were moderately calcified, exhibited amorphous mineralization, and were heterogeneous on post-contrast imaging. Three of the tumors were peripherally enhanced, and regional lymphadenopathy was identified in two of the dogs, which was presumed to be metastatic. No lymph node calcification was reported. Although the presence of intralesional mineralization is not a pathognomonic finding, it was consistently identified in the present case series. Therefore, exOSA should be considered in the differential diagnosis when mineralization occurs in a mass unrelated to osseous structures.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collection Ct Examinations and Image Analysismentioning

confidence: 99%

Case Series: Computed Tomography Features of Extraskeletal Osteosarcoma in Six Dogs

Jeong,

Kim,

Kim

et al. 2024

Veterinary Sciences

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“…On imaging, retroperitoneal EOS are often deep-seated tumours with a large, well-developed calcification matrix with heterogeneous, necrotic soft tissue tumour growth, and invasion into surrounding muscles and abdominopelvic organs. Conversely, osteosarcomatous DDLPS often shows coarse, but less well developed, calcifications, with surrounding neoplastic adipose tissue, and abdominopelvic organ invasion [132,133]. Unlike Ewing sarcoma, the management of primary retroperitoneal EOS follows accepted guidelines for RPS or primary soft-tissue tumours, and not intraosseous osteosarcoma [29,120].…”

Section: Extraosseous Osteosarcomamentioning

confidence: 99%

Practical Management of Adult Ultra-Rare Primary Retroperitoneal Soft Tissue Sarcoma: A Focus on Perivascular Epithelioid Tumours and Extraosseous Ewing Sarcoma

et al. 2023

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With the exception of well-differentiated liposarcoma, dedifferentiated liposarcoma, leiomyosarcoma, solitary fibrous tumour, malignant peripheral nerve sheath tumour, and undifferentiated pleomorphic sarcoma, the majority of the ≈70 histologic subtypes of retroperitoneal sarcoma are defined as ‘ultra-rare’ sarcomas, with an incidence of ≤1–5/1,000,000 persons/year. For most of these ultra-rare RPS subtypes, diagnosis and treatment follows international guidelines for the management of more common RPS histologies, with en bloc surgical resection as the mainstay of curative treatment, and enrolment in clinical trials where possible. Because the treatment of RPS is heavily driven by histology, the surgeon must be familiar with specific issues related to the diagnosis and management of ultra-rare sarcoma subtypes. Expert radiological and surgeon reviews are required to differentiate similarly presenting tumours where surgery can be avoided (e.g., angiomyolipoma), or where upfront systemic therapy is indicated (e.g., extraosseous Ewing’s sarcoma). Thus, the management of all retroperitoneal sarcomas should occur at a sarcoma referral centre, with a multidisciplinary team of experts dedicated to the surgical and medical management of these rare tumours. In this focused review, we highlight how diagnosis and management of the ultra-rare primary RPS histologies of malignant perivascular epithelioid cell tumour (PEComa), extraosseous Ewing sarcoma (EES), extraosseous osteosarcoma (EOS), and rhabdomyosarcoma (RMS) critically diverge from the management of more common RPS subtypes.

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Predicting the Malignancy Grade of Soft Tissue Sarcomas on MRI Using Conventional Image Reading and Radiomics

Schmitz,

Voigtländer,

Jang

et al. 2024

Diagnostics

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Objectives: This study aims to investigate MRI features predicting the grade of STS malignancy using conventional image reading and radiomics. Methods: Pretherapeutic imaging data regarding size, tissue heterogeneity, peritumoral changes, necrosis, hemorrhage, and cystic degeneration were evaluated in conventional image reading. Furthermore, the tumors’ apparent diffusion coefficient (ADC) values and radiomics features were extracted and analyzed. A random forest machine learning algorithm was trained and evaluated based on the extracted features. Results: A total of 139 STS cases were included in this study. The mean tumor ADC and the ratio between tumor ADC to healthy muscle ADC were significantly lower in high-grade tumors (p = 0.001 and 0.005, respectively). Peritumoral edema (p < 0.001) and peritumoral contrast enhancement (p < 0.001) were significantly more extensive in high-grade tumors. Tumor heterogeneity was significantly increased in high-grade sarcomas, particularly in T2w- and contrast-enhanced sequences using conventional image reading (p < 0.001) as well as in the radiomics analysis (p < 0.001). Our trained random forest machine learning model predicted high-grade status with an area under the curve (AUC) of 0.97 and an F1 score of 0.93. Biopsy-underestimated tumors exhibited differences in tumor heterogeneity and peritumoral changes. Conclusions: Tumor heterogeneity is a key characteristic of high-grade STSs, which is discernible through conventional imaging reading and radiomics analysis. Higher STS grades are also associated with low ADC values, peritumoral edema, and peritumoral contrast enhancement.

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Imaging presentation of extraskeletal osteosarcomas on CT and MRI and correlation with patients outcome: A two-center retrospective study of 54 patients

Cited by 4 publications

References 33 publications

Case Series: Computed Tomography Features of Extraskeletal Osteosarcoma in Six Dogs

Case Series: Computed Tomography Features of Extraskeletal Osteosarcoma in Six Dogs

Practical Management of Adult Ultra-Rare Primary Retroperitoneal Soft Tissue Sarcoma: A Focus on Perivascular Epithelioid Tumours and Extraosseous Ewing Sarcoma

Predicting the Malignancy Grade of Soft Tissue Sarcomas on MRI Using Conventional Image Reading and Radiomics

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