MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions

Objective: Chemical shift artefact (CSA) is often encountered during MRI evaluation of superficial soft tissue masses. The study aim was to determine the incidence and diagnostic relevance of CSA in a consecutive series of superficial soft tissue masses referred to a specialist musculoskeletal sarcoma service. Methods: All patients referred over a 6 month period with a non-lipomatous superficial soft tissue mass were prospectively analysed. Patients characteristics (age, gender), lesion features (anatomical location, size, relationship to the skin and deep fascia), presence of CSA and final histopathological diagnosis were collected. The presence of CSA was statistically analysed against these clinical, imaging and histopathological variables. Results: 128 patients fulfilled the inclusion criteria [63 males, 65 females; mean age = 50.6 years (7–96 years)]. CSA was present in 50 cases (39.1%) overall, but in 39 (41.5%) of 94 cases with histological diagnosis. There was no statistically significant relationship to any assessed variable apart from relationship to the deep fascia, CSA being more frequent in lesions contacting the fascia compared to lesions contacting both skin and fascia (p-value 0.02). In particular, the presence of CSA did not allow differentiation between non-malignant and malignant lesions. Conclusion: The presence of CSA is a not infrequent finding in the MRI assessment of superficial soft tissue masses but does not appear to be of any significance in differentiating between non-malignant and malignant lesions. Advances in knowledge: CSA is a relatively common finding in association with superficial soft tissue masses, but does not indicate a particular histological diagnosis or help in the differentiation of non-malignant from malignant lesions.

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Ultrasound evaluation of superficial soft-tissue masses in paediatric patients – are we able to distinguish malignant tumours from benign masses?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-2007-989068 ◽

2007 ◽

Vol 28 (S 1) ◽

Author(s):

M Piskunowicz ◽

W Kosiak ◽

D Swieton ◽

T Stachowicz-Stencel

Keyword(s):

Soft Tissue ◽

Malignant Tumours ◽

Paediatric Patients ◽

Ultrasound Evaluation ◽

Soft Tissue Masses ◽

Superficial Soft Tissue

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Color doppler ultrasonography of soft-tissue masses

Acta Radiologica ◽

10.1080/02841859809172457 ◽

1998 ◽

Vol 39 (4) ◽

pp. 421-426 ◽

Cited By ~ 17

Author(s):

R. Lagalla ◽

A. Iovane ◽

G. Caruso ◽

M. Lo Bello ◽

L. E. Derchi

Keyword(s):

Soft Tissue ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Soft Tissue Tumors ◽

Color Doppler Ultrasonography ◽

Tissue Mass ◽

Vascular Impedance ◽

The Us ◽

Soft Tissue Masses ◽

Malignant Lesions

Purpose: To evaluate the capability of color Doppler ultrasonography to differentiate between benign and malignant soft-tissue tumors. Material and Methods: We reviewed the ultrasonographic (US) and color Doppler (CD) findings in 46 consecutive patients with a palpable periskeletal mass. The presence of 3 or more vascular hila and of tortuous and irregular internal vessels within the lesions was considered an indication of malignancy. The CD diagnosis was compared with that obtained at US alone. Results: The sensitivity and specificity of CD were respectively 85% and 92%; these values were higher than those obtained at US alone, respectively 75% and 50%. Arteriovenous malformations presented as lesions with large internal vessels that had low vascular impedance and were easily diagnosed. The waveform patterns within solid tumors were not specific. Conclusion: At present, US is commonly employed to confirm the presence of a suspected soft-tissue mass, to locate it accurately, and to indicate its nature. CD findings enhance the role of the US technique in such lesions. The combined use of US and CD can allow the differentiation of benign from malignant lesions, and thus provide a better basis for treatment.

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Assessment of Referrals into the Soft Tissue Sarcoma Service: Evaluation of Imaging Early in the Pathway Process

Sarcoma ◽

10.1155/2012/781723 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Emma Rowbotham ◽

Shaheel Bhuva ◽

Harun Gupta ◽

Philip Robinson

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Service Evaluation ◽

Lesion Size ◽

Imaging Diagnosis ◽

Local Hospital ◽

Patient Demographics ◽

Tertiary Centre ◽

Soft Tissue Masses ◽

Malignant Lesions

Purpose. To prospectively evaluate regional referrals into a soft tissue sarcoma service from outside the tertiary centre with local hospital imaging.Materials and Methods. Consecutive referrals were prospectively assessed for: patient demographics, source, referral date, date received by Multidisciplinary Team (MDT), lesion size, local radiology, MDT radiology and final diagnoses. Radiology diagnosis was categorised benign, indeterminate or malignant by consensus. Delays were defined as >10 days.Results. 112 patients were included with high correlation between local and MDT radiology categrorisation and histology (P=0.54andP=0.49, resp.). There was only a trend for MDT radiology diagnosis to downgrade local imaging diagnosis (n=15,P>0.05). 48 cases (43%) had ultrasound and MRI at referral and 20 (18%) ultrasound only. 85% of cases were benign (lipoma most common), 15% malignant (sarcoma most common). Delay occurred in 34% of cases.Discussion. In comparison to previous series these results show a reduction in benign lesions, increased biopsy and malignancy rate for lesions referred to a tertiary centre when imaging is performed and reviewed by local radiologists.Advances in Knowledge. Imaging triage of soft tissue masses can decrease benign referral rates and increase the proportion of indeterminate and malignant lesions referred to specialist centres.

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The Role of Ultrasound in the Diagnosis of Soft Tissue Tumors

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0039-3402060 ◽

2020 ◽

Vol 24 (02) ◽

pp. 135-155

Author(s):

Maria Pilar Aparisi Gómez ◽

Costantino Errani ◽

Radhesh Lalam ◽

Violeta Vasilevska Nikodinovska ◽

Stefano Fanti ◽

...

Keyword(s):

Soft Tissue ◽

Benign Lesion ◽

Soft Tissue Tumors ◽

Resonance Imaging ◽

Benign Lesions ◽

Tumor Center ◽

Soft Tissue Masses ◽

Magnetic Resonance Imaging Mri ◽

Superficial Soft Tissue

AbstractThe vast majority of soft tissue masses are benign. Benign lesions such as superficial lipomas and ganglia are by far the most common soft tissue masses and can be readily identified and excluded on ultrasound (US). US is an ideal triaging tool for superficial soft tissue masses. Compared with magnetic resonance imaging (MRI), High-resolution US is inexpensive, readily available, well tolerated, and safe. It also allows the radiologist to interact with the patient as a clinician. In this review, we describe and illustrate the lesions with typical (diagnostic) US features. When the appearances of the lesion are not typical as expected for a benign lesion, lesions are deep or large, or malignancy is suspected clinically, MRI and biopsy are needed. The management of suspicious soft tissue tumors has to be carefully planned by a multidisciplinary team involving specialized surgeons and pathologists at a tumor center.

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Diffusion weighted MRI of soft tissue masses: Can measurement of ADC value help in the differentiation between benign and malignant lesions?

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2018.04.008 ◽

2018 ◽

Vol 49 (3) ◽

pp. 681-688

Author(s):

Omar A. Hassanien ◽

Rasha Lotfy Younes ◽

Rasha M. Dawoud

Keyword(s):

Soft Tissue ◽

Diffusion Weighted Mri ◽

Adc Value ◽

Diffusion Weighted ◽

Soft Tissue Masses ◽

Malignant Lesions

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2059041 The Role of Ultrasound in The Evaluation of Superficial Soft Tissue Masses

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2014.12.436 ◽

2015 ◽

Vol 41 (4) ◽

pp. S106

Author(s):

Nurul Adliah Gazali ◽

Denise Si Min Lau ◽

Rafidah Abu Bakar ◽

Chandra Mohan P

Keyword(s):

Soft Tissue ◽

Soft Tissue Masses ◽

Superficial Soft Tissue

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Small indeterminate superficial soft tissue masses: relationship between depth and histological grade

British Journal of Radiology ◽

10.1259/bjr.20191037 ◽

2020 ◽

Vol 93 (1110) ◽

pp. 20191037

Author(s):

Michael Khoo ◽

Ian Pressney ◽

Craig Gerrand ◽

Asif Saifuddin

Keyword(s):

Soft Tissue ◽

Soft Tissue Mass ◽

Histological Grade ◽

Definitive Treatment ◽

Excision Biopsy ◽

Anatomical Location ◽

Intermediate Grade ◽

Tissue Mass ◽

Soft Tissue Masses ◽

Superficial Soft Tissue

Objective: To determine whether the location of a small, indeterminate soft tissue mass within the subcutaneous compartment is related to its histological grade. Methods: All Sarcoma Service referrals over a 12 month period of small (<3 cm) superficial soft tissue masses, indeterminate by MRI evaluation which subsequently underwent primary excision biopsy were included. Lesions were categorised by their anatomical location in the subcutaneous compartment. Histopathological diagnoses were categorized according to 12 WHO 2013. χ2 statistical analysis was performed to determine the relationship between lesion depth and histological grade. Results: The study included 43 patients, mean age 42 years (range 15–71 years). Within the subcutaneous compartment, 16 lesions were categorized as superficial, 9 lesions central and 18 lesions deep, of which 9 were non-neoplastic, 29 benign, 1 intermediate-grade and 4 malignant. Location in the deep aspect of the subcutaneous compartment was associated with a higher risk of intermediate or malignant histology (p = 0.02). Conclusion: The location of a small, indeterminate soft tissue mass within the subcutaneous compartment may be an indicator of histological aggressiveness. Lesions in the deep subcutaneous compartment are more likely to be intermediate-grade/malignant lesions. Therefore, if considering excision biopsy as definitive treatment, a wider margin may be appropriate. Advances in knowledge: Small, indeterminate soft tissue masses can be aggressive and the anatomical depth within the subcutaneous tissue may be a potential indicator of histological aggressiveness.

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