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Diffusion-weighted imaging for the cellularity assessment and matrix characterization of soft tissue tumour

  • ONCOLOGY IMAGING
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Abstract

Purpose

To evaluate whether apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) is able to investigate the histological features of soft tissue tumours.

Methods

We reviewed MRIs of soft tissue tumours performed from 2012 to 2015 to calculate the average ADCs. We included 46 patients (27 male; mean age: 57 years, range 12–85 years) with histologically proven soft tissue tumours (10 benign, 2 intermediate 34 malignant) grouped into eight tumour type classes. An experienced pathologist assigned a semi-quantitative cellularity score (very high, high, medium and low) and tumour grading. The t test, ANOVA and linear regression were used to correlate ADC with clinicopathological data. Approximate receiver operating characteristic curves were created to predict possible uses of ADC to differentiate benign from malignant tumours.

Results

There was a significant difference (p < 0.01) in ADCs between these three groups excluding myxoid sarcomas. A significant difference was also evident between the tumour type classes (p < 0.001), grade II and III myxoid lesions (p < 0.05), tumour grading classes (p < 0.001) and cellularity scores classes (p < 0.001), with the lowest ADCs in the very high cellularity. While the linear regression analysis showed a significant relationship between ADC and tumour cellularity (r = 0.590, p ≤ 0.05) and grading (r = 0.437, p ≤ 0.05), no significant relationship was found with age, gender, tumour size and histological subtype. An optimal cut-off ADC value of 1.45 × 10−3 mm2/s with 76.8% accuracy was found to differentiate benign from malignant tumours.

Conclusions

DWI may offer adjunctive information about soft tissue tumours, but its clinical role is still to be defined.

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References

  1. Mu-Koh D, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR 188:1622–1635

    Article  Google Scholar 

  2. Tsushima Y, Takahashi-Taketomi A, Endo K (2009) Magnetic resonance (MR) differential diagnosis of breast tumours using apparent diffusion coefficient (ADC) on 1.5-T. J Magn Reson Imaging 30:249–255

    Article  PubMed  Google Scholar 

  3. Higano S, Yun X, Kurnabe T et al (2006) Malignant astrocytic tumours: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology 241:839–846

    Article  PubMed  Google Scholar 

  4. Bulakbasi N, Guvenc I, Onguru O et al (2004) The added value of the apparent diffusion coefficient to magnetic resonance imaging in the differentiation and grading of malignant brain tumours. J Comput Assist Tomogr 28:735–746

    Article  PubMed  Google Scholar 

  5. Schnapauff D, Zeile M, Niederhagen MB et al (2009) Diffusion-weighted echo-planar magnetic resonance imaging for the assessment of tumour cellularity in patients with soft-tissue sarcomas. J Magn Reson Imaging 29:1355–1359

    Article  PubMed  Google Scholar 

  6. Dudeck O, Zeile M, Pink D et al (2008) Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging 27:1109–1113

    Article  PubMed  Google Scholar 

  7. Maeda M, Matsumine A, Kato H et al (2007) Soft-tissue tumours evaluated by line-scan diffusion-weighted imaging: influence of myxoid matrix on the apparent diffusion coefficient. J Magn Reson Imaging 25:1199–1204

    Article  PubMed  Google Scholar 

  8. Nagata S, Nishimura H, Uchida M et al (2008) Diffusion-weighted imaging of soft tissue tumours: usefulness of the apparent diffusion coefficient for differential diagnosis. Radiat Med 26:287–295

    Article  PubMed  Google Scholar 

  9. Einarsdóttir H, Karlsson M, Wejde J et al (2004) Diffusion-weighted MRI of soft tissue tumours. Eur Radiol 14:959–963

    Article  PubMed  Google Scholar 

  10. Lecouvet FE (2016) Whole-body MR imaging: musculoskeletal applications. Radiology 279:345–365

    Article  PubMed  Google Scholar 

  11. Albano D, La Grutta L, Grassedonio E, Patti C, Lagalla R, Midiri M et al (2016) Pitfalls in whole body MRI with diffusion weighted imaging performed on patients with lymphoma: what radiologists should know. Magn Res Imaging 34:922–931

    Article  Google Scholar 

  12. Costa FM, Ferreira EC, Vianna EM (2011) Diffusion-weighted magnetic resonance imaging for the evaluation of musculoskeletal tumours. Magn Reson Imaging Clin N Am 19:159–180

    Article  PubMed  Google Scholar 

  13. Khoo MM, Tyler PA, Saiffudin A, Padhani AR (2011) Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review. Skelet Radiol 40:665–681

    Article  Google Scholar 

  14. Fletcher C, Bridge J, Hogendoorn P et al (2013) WHO classification of tumours of soft tissue and bone. Pathology and genetics of soft tissues and bone. IARC Press, Lyon

    Google Scholar 

  15. Trojani M, Contesso G, Coindre JM et al (1984) Soft-tissue sarcoma of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 33:37–42

    Article  CAS  PubMed  Google Scholar 

  16. Kransdrof MJ, Murphey MD (2000) Radiologic evaluation of soft-tissue masses: a current perspective. AJR 175:575–587

    Article  Google Scholar 

  17. Hayashida Y, Hirai T, Morishita S et al (2006) Diffusion-weighted imaging of metastatic brain tumours: comparison with histologic type and tumour cellularity. Am J Neuroradiol 27:1419–1425

    CAS  PubMed  Google Scholar 

  18. Albano D, Patti C, Lagalla R, Midiri M, Galia M (2016) Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma. J Magn Reson Imaging. doi:10.1002/jmri.25439

    PubMed  Google Scholar 

  19. Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635

    Article  PubMed  Google Scholar 

  20. Stecco A, Buemi F, Cassarà A, Matheoud R, Sacchetti GM, Arnulfo A, Brambilla M, Carriero A (2016) Comparison of retrospective PET and MRI-DWI (PET/MRI-DWI) image fusion with PET/CT and MRI-DWI in detection of cervical and endometrial cancer lymph node metastases. Radiol Med 121(7):537–545

    Article  PubMed  Google Scholar 

  21. Van Rijswijk CS, Kunz P, Hogendoorn PC et al (2002) Diffusion-weighted MRI in the characterization of soft-tissue tumours. J Magn Reson Imaging 15(3):302–307

    Article  PubMed  Google Scholar 

  22. Razek A, Nada N, Ghaniem M, Elkhamary S (2012) Assessment of soft tissue tumours of the extremities with diffusion echo planar Mr imaging. Radiol Med 117:96–101

    Article  CAS  PubMed  Google Scholar 

  23. Surov Nagata S, Razek AA, Tirumani SH, Wienke A, Kahn T (2015) Comparison of ADC values in different malignancies of the skeletal musculature: a multicentric analysis. Skelet Radiol 44:995–1000

    Article  Google Scholar 

  24. Albano D, Patti C, La Grutta L, Agnello F, Grassedonio E, Mulè A et al (2016) Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 85:313–318

    Article  PubMed  Google Scholar 

  25. Galia M, Albano D, Narese D, Patti C, Chianca V, Di Pietto F et al (2016) Whole-body MRI in patients with lymphoma: collateral findings. Radiol Med 121:793–800

    Article  PubMed  Google Scholar 

  26. Teixeira PA, Beaumont M, Gabriela H et al (2015) Advanced techniques in musculoskeletal oncology: perfusion, diffusion, and spectroscopy. Semin Musculoskelet Radiol 19:463–474

    Article  PubMed  Google Scholar 

  27. Lee SY, Jee WH, Jung JY et al (2016) 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. Eur Radiol 26:743–754

    Article  PubMed  Google Scholar 

  28. Wu JS, Hochman MG (2009) Soft-tissue tumours and tumour like lesions: a systematic imaging approach. Radiology 253:297–316

    Article  PubMed  Google Scholar 

  29. Weiss SW, Goldblun JR (2001) Myxoid sarcoma. Enzinger and Weiss’s soft tissue tumours. Mosby, St. Louis, pp 150–156

    Google Scholar 

  30. Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Van Rijswijk CS, Kunz P, Hogendoorn PC, Taminiau AH, Doornbos J, Bloem JL (2002) Diffusion-weighted MRI in the characterization of soft-tissue tumours. J Magn Reson Imaging 15:302–307

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Dipartimento di Radiologia, Azienda Ospedaliera Città della Salute e della Scienza, Centro Traumatologico Ortopedico, Via Zuretti 29, 10126, Torino, Italy

    Tiziana Robba, Guido Regis & Alda Borrè

  2. Dipartimento di Scienze Biomediche Avanzate, Università degli studi Federico II, Via Pansini 5, 80131, Napoli, Italy

    Vito Chianca

  3. Sezione di Scienze Radiologiche, DIBIMED, Università of Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Domenico Albano

  4. Ospedale Sacro Cuore Don Calabria, Via Don A. Sempreboni, 5, 37024, Negrar, Italy

    Valeria Clementi

  5. Department of Orthopaedic Oncology, Azienda Ospedaliera Città della Salute e della Scienza, Centro Traumatologico Ortopedico, Via Zuretti 29, 10126, Torino, Italy

    Raimondo Piana

  6. Department of Pathology, Città della Salute e della Scienza-OIRM, piazza Polonia 94, 10126, Torino, Italy

    Alessandra Linari

  7. Department of Medical Oncology, Gradenigo Hospital, Corso Regina Margherita 8, 10153, Torino, Italy

    Alessandro Comandone

  8. Centro diagnostico J-Medical, via Druento 153/56, 10151, Torino, Italy

    Maurizio Stratta

  9. Unità di Diagnostica per Immagini, Casa di cure Fornaca, Corso Vittorio Emanuele 91, 10126, Torino, Italy

    Carlo Faletti

Authors
  1. Tiziana Robba
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  2. Vito Chianca
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  3. Domenico Albano
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  4. Valeria Clementi
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  6. Alessandra Linari
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  7. Alessandro Comandone
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  8. Guido Regis
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  9. Maurizio Stratta
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Corresponding author

Correspondence to Vito Chianca.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Institutional review board approval was obtained for this retrospective study with a waiver of the requirement for informed consent.

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Robba, T., Chianca, V., Albano, D. et al. Diffusion-weighted imaging for the cellularity assessment and matrix characterization of soft tissue tumour. Radiol med 122, 871–879 (2017). https://doi.org/10.1007/s11547-017-0787-x

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  • DOI: https://doi.org/10.1007/s11547-017-0787-x

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