Alessandro Coran1, Paolo Ortolan2, Shady Attar2, Enrico Alberioli2, Egle Perissinotto3, Anna Lisa Tosi4, Maria Cristina Montesco4, Carlo Riccardo Rossi5, Saveria Tropea5, Marco Rastrelli6, Roberto Stramare2. 1. Department of Radiology and Medical Physics, Oncologic Radiology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy. 2. Department of Medicine, Radiology Unit, University of Padova, Padua, Italy. 3. Department of Biostatistics, Public Health Unit, University of Padova, Padua, Italy. 4. Department of General Health Services, Pathology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy. 5. Department of Surgical Oncology, Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy. 6. Department of Surgical Oncology, Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy marco.rastrelli@iov.veneto.it.
Abstract
AIM: To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. MATERIALS AND METHODS: A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher's exact test), inter-operator agreement (Cohen's kappa), association of MRI findings and malignancy of the lesion (Fisher's exact test and odds ratio) were evaluated. RESULTS: The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). CONCLUSION: MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). Copyright
AIM: To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. MATERIALS AND METHODS: A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher's exact test), inter-operator agreement (Cohen's kappa), association of MRI findings and malignancy of the lesion (Fisher's exact test and odds ratio) were evaluated. RESULTS: The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). CONCLUSION: MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). Copyright
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