MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions.

Moulton, Jonathan S.; Blebea, John; Dunco, Doug; Braley, Susan; Bisset, George S.; Emery, Kathleen H.

doi:10.2214/ajr.164.5.7717231

Cited by 166 publications

(95 citation statements)

References 13 publications

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“…CT and MRI offer the most accurate imaging of the local extent of malignant bone tumours. 23 Ewing's sarcoma is a highly cellular tumour with a limited matrix and often shows marked changes in the extraosseous volume after chemotherapy. By contrast, osteosarcoma has a large extracellular matrix of bone and osteoid which requires active resorption by osteoclasts for its removal.…”

Section: Discussionmentioning

confidence: 99%

Tumour volume as a predictor of necrosis after chemotherapy in Ewing’s sarcoma

Abudu

Davies

Pynsent

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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We studied the CT and MR scans, and the histology of 50 patients with primary Ewing's sarcoma of bone to determine the association between the change in tumour volume and necrosis after chemotherapy, and to ascertain their influence on prognosis. The mean age of the patients was 17 years. The limbs were involved in 40 and the axial bones in ten. The volume of the tumour at diagnosis varied from 31 to 1790 ml.There was a significant relationship between necrosis and the measured change in volume of the tumour after chemotherapy. Progression of the tumour despite chemotherapy was seen only in patients with necrosis of grades 4 to 6. Necrosis significantly influenced survival (p < 0.05), but the effect of change in volume was less significant.Change in volume of the tumour is a good predictor of necrosis induced by chemotherapy. Necrosis is a strong prognostic factor in Ewing's sarcoma.

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Section: Discussionmentioning

confidence: 99%

Tumour volume as a predictor of necrosis after chemotherapy in Ewing’s sarcoma

Abudu

Davies

Pynsent

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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“…On the basis of results from various studies (2,3,93,94), it is estimated that the ability of MR imaging to characterize lesion histologic characteristics is quite low, often less than 50%. This is especially true when lipomas and cysts are excluded from the analysis (95). Delayed contrast-enhanced MR imaging has been studied for the characterization of lesions, mainly for distinguishing benignity and malignancy, and has shown some promise (85,96).…”

Section: Characterizationmentioning

confidence: 99%

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

Jacobs²,

et al. 2012

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“…37 Once cystic, lipomatous, and vascular lesions have been ruled out, it is estimated that the ability of MRI to accurately characterize lesions is low, often ,50%. [38][39][40][41] Patterns of contrast enhancement in benign and malignant lesions overlap, 38 and with DCE-MRI malignant lesions typically demonstrate rapid early arterial enhancement and higher slopes of enhancement compared with benign lesions, 15,[17][18][19] but this pattern is not entirely specific (Fig 3). Finally, MRS is an emerging technique that has recently been applied to the characterization of musculoskeletal tumors.…”

Section: Figurementioning

confidence: 99%

De Novo Assessment of Pediatric Musculoskeletal Soft Tissue Tumors: Beyond Anatomic Imaging

Ahlawat

Fayad

2015

Pediatrics

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MRI plays a central role in the assessment of pediatric musculoskeletal soft tissue tumors. Although these neoplasms may initially be evaluated on other modalities, such as sonography, MRI is essential for accurately determining the extent of disease. Traditionally, MRI has been performed with sequences that provide excellent anatomic detail, with T1-weighted, fluid-sensitive, and static postcontrast T1-weighted sequences. However, with the introduction of noncontrast sequences such as diffusion-weighted imaging and magnetic resonance spectroscopy to the arsenal of available MRI techniques, functional and metabolic features of a neoplasm can now be examined noninvasively. These more recent MRI methods offer information for lesion characterization, the assessment of treatment response, and the distinction of postoperative scar from recurrence. Dynamic contrast-enhanced perfusion imaging is another useful functional technique that can be acquired before conventional static postcontrast imaging, without requiring additional contrast material. This review presents recent advances in MRI methodology that enable a comprehensive clinical assessment of musculoskeletal tumors in the pediatric population. The roles and challenges of combining anatomic, functional, and metabolic MRI sequences will be discussed as they relate to newly discovered soft tissue tumors in children.A principal role for MRI in the evaluation of pediatric musculoskeletal tumors is the determination of extent of disease for appropriate preoperative planning. Diffusion-weighted imaging (DWI), dynamic contrast-enhanced perfusion imaging (DCE-MRI), and magnetic resonance spectroscopy (MRS) have expanded the role of MRI to include lesion characterization, treatment response, and the detection of postsurgical recurrence. In this review, conventional (anatomic sequences) and advanced (functional and metabolic sequences) imaging will be discussed, with an emphasis on how these sequences are used in the clinical setting of newly discovered (de novo) pediatric soft tissue tumors. The assessment of treatment response and postsurgical recurrence is beyond the scope of this article. CHALLENGES IN THE PEDIATRIC PATIENTPediatric imaging presents unique challenges that are not encountered in the adult setting. The need for sedation in young children requires that a comprehensive protocol also be succinct. A complete tumor protocol that includes anatomic, functional, and metabolic sequences has been previously described. 1 The examination requires 60 minutes, with 15 minutes of this time allotted to MRS if desired (see Table 1).Additional challenges encountered in pediatric patients include their small size with resultant decreased signal and inherently low scan resolution.

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MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions.

Cited by 166 publications

References 13 publications

Tumour volume as a predictor of necrosis after chemotherapy in Ewing’s sarcoma

Tumour volume as a predictor of necrosis after chemotherapy in Ewing’s sarcoma

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

De Novo Assessment of Pediatric Musculoskeletal Soft Tissue Tumors: Beyond Anatomic Imaging

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