Ji Hyun Lee1, Hyun Su Kim1, Young Cheol Yoon1, Sung Wook Seo2, Min Jae Cha3, Wook Jin4, Jang Gyu Cha5. 1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea. 4. Department of Radiology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea. 5. Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Abstract
OBJECTIVES: To compare magnetic resonance imaging (MRI) parameters of small, deeply located non-malignant and malignant soft-tissue tumors (STTs). METHODS: Between May 2011 and December 2017, 95 MRIs in 95 patients with pathologically proven STTs of small size (<5 cm) and deep location (66 non-malignant and 29 malignant) were identified. For qualitative parameters, consensus reading was performed by three radiologists for presence of necrosis, infiltration, lobulation, and the tail sign. Apparent diffusion coefficient (ADC) was analyzed by two other radiologists independently. Univariable and multivariable analyses were performed to determine the diagnostic performances of MRI parameters in differentiating non-malignancy and malignancy, and for non-myxoid, non-hemosiderin STTs and myxoid STTs as subgroups. Interobserver agreement for ADC measurement was calculated with the intraclass correlation coefficient. RESULTS: Interobserver agreement on ADC measurement was almost perfect. On univariable analysis, the malignant group showed a significantly larger size, lower ADC, and higher incidence of all qualitative MRI parameters for all STTs. Size (p = 0.012, odds ratio [OR] 2.57), ADC (p = 0.041, OR 3.85), and the tail sign (p = 0.009, OR 6.47) were independently significant on multivariable analysis. For non-myxoid, non-hemosiderin STTs, age, size, ADC, frequency of infiltration, lobulation, and the tail sign showed significant differences between non-malignancy and malignancy on univariable analysis. Only ADC (p = 0.032, OR 142.86) retained its independence on multivariable analysis. For myxoid STTs, only size and tail sign were significant on univariable analysis without independent significance. CONCLUSIONS: Size, ADC, and incidence of qualitative MRI parameters were significantly different between small, deeply located non-malignant and malignant STTs. Only ADC was independently significant for both overall analysis and the non-myxoid, non-hemosiderin subgroup.
OBJECTIVES: To compare magnetic resonance imaging (MRI) parameters of small, deeply located non-malignant and malignant soft-tissue tumors (STTs). METHODS: Between May 2011 and December 2017, 95 MRIs in 95 patients with pathologically proven STTs of small size (<5 cm) and deep location (66 non-malignant and 29 malignant) were identified. For qualitative parameters, consensus reading was performed by three radiologists for presence of necrosis, infiltration, lobulation, and the tail sign. Apparent diffusion coefficient (ADC) was analyzed by two other radiologists independently. Univariable and multivariable analyses were performed to determine the diagnostic performances of MRI parameters in differentiating non-malignancy and malignancy, and for non-myxoid, non-hemosiderin STTs and myxoid STTs as subgroups. Interobserver agreement for ADC measurement was calculated with the intraclass correlation coefficient. RESULTS: Interobserver agreement on ADC measurement was almost perfect. On univariable analysis, the malignant group showed a significantly larger size, lower ADC, and higher incidence of all qualitative MRI parameters for all STTs. Size (p = 0.012, odds ratio [OR] 2.57), ADC (p = 0.041, OR 3.85), and the tail sign (p = 0.009, OR 6.47) were independently significant on multivariable analysis. For non-myxoid, non-hemosiderin STTs, age, size, ADC, frequency of infiltration, lobulation, and the tail sign showed significant differences between non-malignancy and malignancy on univariable analysis. Only ADC (p = 0.032, OR 142.86) retained its independence on multivariable analysis. For myxoid STTs, only size and tail sign were significant on univariable analysis without independent significance. CONCLUSIONS: Size, ADC, and incidence of qualitative MRI parameters were significantly different between small, deeply located non-malignant and malignant STTs. Only ADC was independently significant for both overall analysis and the non-myxoid, non-hemosiderin subgroup.