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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(01): 70-77
DOI: 10.4103/ijri.IJRI_251_17
Musculoskeletal Radiology

Can MRI diffusion-weighted imaging identify postoperative residual/recurrent soft-tissue sarcomas?

Mai Maher ElDaly
Department of Diagnostic and Intervention Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Amr Farouk Ibrahim Moustafa
Department of Diagnostic and Intervention Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Suzan Mohamed Samy Abdel-Meguid
Department of Diagnostic and Intervention Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
,
Ahmed Mohamed Shokry
Department of Diagnostic and Intervention Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
,
Nagui Abd El Wahab
Department of Diagnostic and Intervention Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Subject Editor: Financial support and sponsorship Nil.
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Abstract

Purpose: The aim of this study was to evaluate contrast-enhanced magnetic resonance imaging (CE-MRI) and quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in the detection of recurrent/residual postoperative soft tissue sarcomas. Materials and Methods: This study included 36 patients; 27 patients had postoperative recurrent/residual soft tissue sarcomas and 9 patients had postoperative and treatment-related changes (inflammation/fibrosis). The DWI was obtained with 3 b values including 0, 400, and 800 s/mm2. Calculation of the ADC value of the lesion was done via placing the region of interest (ROI) to include the largest area of the lesion. ADC values were compared to histopathology. Results: Our results showed that including CE-MRI improved the diagnostic accuracy and sensitivity in recurrence detection compared to conventional non-enhanced sequences. However, it showed low specificity (55.56%) with a high false-positive rate that may lead to an unnecessary biopsy of a mass such as region of postoperative scar tissue. Conclusion: The joint use of gadolinium-enhanced MRI and quantitative DWI with ADC mapping offer added value in the detection of recurrent/residual postoperative soft tissue sarcoma. This combined use increased both the diagnostic sensitivity and specificity with a cut-off average ADC value for detecting nonmyxoid recurrent/residual lesions ≤1.3 × 10−3 mm2/s (100% specificity and 90.48% sensitivity). Our results showed limited value of DWI with ADC mapping in assessing myxoid sarcomatous tumor recurrences.

Keywords

ADC value - diffusion-weighted imaging - soft tissue sarcoma


Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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