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Eur Radiol. 2016 Mar;26(3):743-54. doi: 10.1007/s00330-015-3878-x. Epub 2015 Jun 17.

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T.

Author information

1
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea, 137-701.
2
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyeong-dong, Jongno-gu, Seoul, Korea, 110-746.
3
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea, 137-701. whjee12@gmail.com.
4
Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 665-8 Bupyeong6-dong, Bupyeong-gu, Incheon, Korea, 403-720.
5
Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea, 137-701.
6
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea, 137-701.

Abstract

OBJECTIVES:

To determine the added value of diffusion-weighted imaging (DWI) to standard magnetic resonance imaging (MRI) to differentiate malignant from benign soft tissue tumours at 3.0 T.

METHODS:

3.0 T MR images including DWI in 63 patients who underwent surgery for soft tissue tumours were retrospectively analyzed. Two readers independently interpreted MRI for the presence of malignancy in two steps: standard MRI alone, standard MRI and DWI with qualitative and quantitative analysis combined.

RESULTS:

There were 34 malignant and 29 non-malignant soft tissue tumours. In qualitative analysis, hyperintensity relative to skeletal muscle was more frequent in malignant than benign tumours on DWI (P=0.003). In quantitative analysis, ADCs of malignant tumours were significantly lower than those of non-malignant tumours (P≤0.002): 759±385 vs. 1188±423 μm(2)/sec minimum ADC value, 941±440 vs. 1310±440 μm(2)/sec average ADC value. The mean sensitivity, specificity and accuracy of both readers were 96%, 72%, and 85% on standard MRI alone and 97%, 90%, and 94% on standard MRI with DWI.

CONCLUSIONS:

The addition of DWI to standard MRI improves the diagnostic accuracy for differentiation of malignant from benign soft tissue tumours at 3.0 T.

KEY POINTS:

DWI has added value for differentiating malignant from benign soft tissue tumours. Addition of DWI to standard MRI at 3.0 T improves the diagnostic accuracy. Measurements of both ADC min within solid portion and ADC av are helpful.

KEYWORDS:

Differential diagnosis; Diffusion magnetic resonance imaging; MRI; Sarcoma; Soft tissue neoplasms

PMID:
26080796
DOI:
10.1007/s00330-015-3878-x
[Indexed for MEDLINE]

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