Leonhard Gruber1, Alexander Loizides2, Laurin Ostermann3, Bernhard Glodny1, Michaela Plaikner1, Hannes Gruber1. 1. Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. 2. Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. alexander.loizides@i-med.ac.at. 3. Institute for Theoretical Physics, University of Innsbruck, Technikerstraße 21/3, Innsbruck, Austria.
Abstract
PURPOSE: In this retrospective study we examined whether size is a viable marker of tumour malignancy in soft tissue masses (STM) and if the ratio of width and length (RALD) of an STM reflects tumour biology more accurately. METHODS: Measurements of maximal lesion size and perpendicular diameter were performed in available MRI and ultrasonography studies of 212 patients (mean age 54.4 ± 17.2 years, male:female 1:1.12) with a histologically verified diagnosis. RESULTS: Overall, 28.2 % of lesions were malignant, 11.1 % intermediate, and 58.8 % benign. Size alone was a weak predictor of malignancy in STMs (sensitivity 68.8 %, specificity 50.3 %, positive predictive value [PPV] 44.0 %, negative predictive value [NPV] 80.4 %). RALD showed better discriminatory power with greater separation between benign and malignant entities and higher values for sensitivity (83.6 %), specificity (53.6 %), and NPV (89.0 %). A weighted combination of size, age and RALD improved diagnostic power, demonstrating higher values for sensitivity (77.0 %), specificity (80.1 %), PPV (61.0 %), and NPV (89.6 %). CONCLUSIONS: Size should not be used alone to estimate an STM's malignancy. RALD better reflects a lesion's growth pattern and a combination of age, size, and RALD helps to discriminate more accurately between benign, intermediate, and malignant entities. These findings should help to estimate easily whether a newly found STM is benign or malignant prior to further workup. KEY POINTS: •Size does not reliably differentiate between benign, intermediate, and malignant tumours •The R ALD (ratio of lateral to axial diameter) improves diagnostic confidence •When combined with age and size, STM differentiation was further enhanced •These measurements can aid in earlier detection of sarcomas.
PURPOSE: In this retrospective study we examined whether size is a viable marker of tumour malignancy in soft tissue masses (STM) and if the ratio of width and length (RALD) of an STM reflects tumour biology more accurately. METHODS: Measurements of maximal lesion size and perpendicular diameter were performed in available MRI and ultrasonography studies of 212 patients (mean age 54.4 ± 17.2 years, male:female 1:1.12) with a histologically verified diagnosis. RESULTS: Overall, 28.2 % of lesions were malignant, 11.1 % intermediate, and 58.8 % benign. Size alone was a weak predictor of malignancy in STMs (sensitivity 68.8 %, specificity 50.3 %, positive predictive value [PPV] 44.0 %, negative predictive value [NPV] 80.4 %). RALD showed better discriminatory power with greater separation between benign and malignant entities and higher values for sensitivity (83.6 %), specificity (53.6 %), and NPV (89.0 %). A weighted combination of size, age and RALD improved diagnostic power, demonstrating higher values for sensitivity (77.0 %), specificity (80.1 %), PPV (61.0 %), and NPV (89.6 %). CONCLUSIONS: Size should not be used alone to estimate an STM's malignancy. RALD better reflects a lesion's growth pattern and a combination of age, size, and RALD helps to discriminate more accurately between benign, intermediate, and malignant entities. These findings should help to estimate easily whether a newly found STM is benign or malignant prior to further workup. KEY POINTS: •Size does not reliably differentiate between benign, intermediate, and malignant tumours •The R ALD (ratio of lateral to axial diameter) improves diagnostic confidence •When combined with age and size, STM differentiation was further enhanced •These measurements can aid in earlier detection of sarcomas.
Authors: Sana Boudabbous; Marion Hamard; Essia Saiji; Karel Gorican; Pierre-Alexandre Poletti; Minerva Becker; Angeliki Neroladaki Journal: BJR Open Date: 2022-06-22