Dynamic MRI and fine needle aspiration cytology in the evaluation of soft tissue lesions

• Published in: Skeletal radiology Vol. 32; no. 12; pp. 695 - 700
• Main Authors: EINARSDOTTIR, Hildur, SÖDERLUND, Veli, SKOOG, Lambert, BAUER, Henrik C. F
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.12.2003; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy, Fine-Needle; Breast cancer; Diagnosis, Differential; Diseases of the osteoarticular system; Extremities - diagnostic imaging; Extremities - pathology; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Lipoma - classification; Lipoma - diagnostic imaging; Lipoma - pathology; Magnetic Resonance Imaging; Male; Medical diagnosis; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Radiographic Image Enhancement; Retrospective Studies; Sarcoma - classification; Sarcoma - diagnostic imaging; Sarcoma - pathology; Soft Tissue Neoplasms - classification; Soft Tissue Neoplasms - diagnostic imaging; Soft Tissue Neoplasms - pathology; Traumas. Diseases due to physical agents; Tumors; DMRI; Evaluation; Nuclear medicine; Sarcoma; Cytology; Curve; FNAC; Malignant tumor; Aspiration punction; Nuclear magnetic resonance imaging; Soft tissue tumor; Dynamics; Orthopedics; Radiology; TSI curve; Medical imagery; Soft tissue; Lesion
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-003-0656-7

To assess the usefulness of dynamic magnetic resonance imaging (DMRI) in the diagnosis of soft tissue tumors. A DMRI series of 33 patients with soft tissue lesions was evaluated with regard to start, pattern, and progression of enhancement. Early enhancement, predominantly peripheral, and a time-signal intensity (TSI) curve characterized by a steep rise to an early peak followed by a plateau or washout, were considered signs of malignancy. The results were compared with the initial fine needle aspiration cytology (FNAC) diagnosis and the final diagnosis. Twenty of 23 malignant lesions and three of 10 benign lesions exhibited at least two of the three enhancement characteristics attributed to malignancy. Using two or more DMRI features of malignancy to dichotomize the series, the sensitivity and positive predictive value of the DMRI series were 87% and, the specificity and negative predictive value were 70%. FNAC was conclusive except in two cases. In tumor centers that rely on FNAC for preoperative diagnosis DMRI can be reserved for cytologically inconclusive cases. In centers that rely on open biopsy, DMRI may be useful as a coarse discriminator between benign and malignant lesions. However, larger series of soft tissue tumors need to be evaluated to conclusively identify the clinical role of DMRI.