scholarly journals MRI-based radiomics to predict lipomatous soft tissue tumors malignancy: a pilot study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Benjamin Leporq ◽  
Amine Bouhamama ◽  
Frank Pilleul ◽  
Fabrice Lame ◽  
Catherine Bihane ◽  
...  

Abstract Objectives To develop and validate a MRI-based radiomic method to predict malignancies in lipomatous soft tissue tumors. Methods This retrospective study searched in the database of our pathology department, data from patients with lipomatous soft tissue tumors, with histology and gadolinium-contrast enhanced T1w MR images, obtained from 56 centers with non-uniform protocols. For each tumor, 87 radiomic features were extracted by two independent observers to evaluate the inter-observer reproducibility. A reduction of learning base dimension was performed from reproducibility and relevancy criteria. A model was subsequently prototyped using a linear support vector machine to predict malignant lesions. Results Eighty-one subjects with lipomatous soft tissue tumors including 40 lipomas and 41 atypical lipomatous tumors or well-differentiated liposarcomas with fat-suppressed T1w contrast enhanced MR images available were retrospectively enrolled. Based on a Pearson’s correlation coefficient threshold at 0.8, 55 out of 87 (63.2%) radiomic features were considered reproducible. Further introduction of relevancy finally selected 35 radiomic features to be integrated in the model. To predict malignant tumors, model diagnostic performances were as follow: AUROC = 0.96; sensitivity = 100%; specificity = 90%; positive predictive value = 90.9%; negative predictive value = 100% and overall accuracy = 95.0%. Conclusion This work demonstrates that radiomics allows to predict malignancy in soft tissue lipomatous tumors with routinely used MR acquisition in clinical oncology. These encouraging results need to be further confirmed in an external validation population.

Author(s):  
Armanda De Marchi ◽  
Simona Pozza ◽  
Lorena Charrier ◽  
Filadelfo Cannone ◽  
Franco Cavallo ◽  
...  

Subcutaneous masses smaller than 5 cm can be malignant, in contrast with the international guidelines. Ultrasound (US) and magnetic resonance imaging (MRI) are useful to distinguish a potentially malignant mass from the numerous benign soft tissue (ST) lesions. Contrast-enhanced ultrasound (CEUS) was applied in ST tumors, without distinguishing the subcutaneous from the deep lesions. We evaluated CEUS and MRI accuracy in comparison to histology in differentiating malignant from nonmalignant superficial ST masses, 50% smaller than 5 cm. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) with their 95% confidence intervals (CI) were calculated. Of malignant cases, 44.4% measured ≤5 cm. At univariate analysis, no statistically significant differences emerged between benign and malignant tumors in relation with clinical characteristics, except for relationship with the deep fascia (p = 0.048). MRI accuracy: sensitivity 52.8% (CI 37.0, 68.0), specificity 74.1% (CI 55.3, 86.8), PPV 73.1% (CI 53.9, 86.3), and NPV 54.1% (CI 38.4, 69.0). CEUS accuracy: sensitivity 75% (CI 58.9, 86.3), specificity 37% (CI 21.5, 55.8), PPV 61.4% (CI 46.6, 74.3), and NPV 52.6% (CI 31.7, 72.7). CEUS showed a sensitivity higher than MRI, whereas PPV and NPV were comparable. Also, masses measuring less than 5 cm can be malignant and referral criteria for centralization could be revised.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199399
Author(s):  
Taketsugu Fujibuchi ◽  
Hiroshi Imai ◽  
Joji Miyawaki ◽  
Teruki Kidani ◽  
Hiroshi Kiyomatsu ◽  
...  

Purpose: The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute. Patients and methods: A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed. Results: There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant ( p = 0.031) despite being smaller than other tumors in different body parts. Conclusion: When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.


Author(s):  
Khadija S. Tapadar ◽  
Manoj K. Deka ◽  
R. N. Chaubey ◽  
Shah A. Sheikh ◽  
Gargi R. Choudhury ◽  
...  

Background: Soft tissue tumors are defined as mesenchymal proliferations which occur in the extraskeletal non-epithelial tissues of the body, excluding the viscera, coverings of brain and   lymphoreticular system. The objective of this study was to study the histopathological features of soft tissue tumors and to study the occurrence of soft tissue tumors in relation to age, sex and anatomical site.Methods: This study comprised of 89 cases studied over a period of two years. All soft tissue tumors, their gross features, microscopic findings were analysed in detail. Soft tissue tumors were divided into benign and malignant categories and further sub typing were done according to World Health Organization (WHO) classification. The distribution of soft tissue tumors according to the age, sex and site of occurrence was studied.Results: Out of 89 cases of soft tissue tumors, 76 cases were benign, 4 cases belonged to intermediate category and 9 cases were malignant. Adipocytic tumors formed the largest group constituting 39 cases. Vascular tumors were the second commonest (26 cases) followed by peripheral nerve sheath tumors (11 cases). The benign tumors were seen in younger age as compared to malignant tumors. Malignant soft tissue tumors was seen to be more common in male than female and pleomorphic sarcoma and liposarcoma was commonest (3 cases each).Conclusions: Benign tumors were more common than malignant. The most common benign tumors were lipoma followed by hemangioma and schwannoma. The most common malignant tumor was pleomorphic sarcoma. The benign tumors were seen in younger age as compared to malignant tumors.


2019 ◽  
pp. 49-61
Author(s):  
A. V. Chernaya ◽  
S. N. Novikov ◽  
P. V. Krivorotko ◽  
R. Kh. Ulyanova ◽  
V. V. Danilov

Purpose: to study the possibilities of contrast enhanced dual-energy spectral mammography (CESM) in the diagnostics of malignant tumors in the breast.Material and methods. Forty-seven patients with suspicious for breast cancer (BC) lesions underwent CESM. Digital mammography (MMG) and post-contrast images were correlated with the results of path morphological studies after surgery or puncture biopsy was performed.Results. Sensitivity, specificity and overall accuracy in the diagnostics of breast cancer were 83.3%, 85.7%, 85.1% for digital mammography and 91.6%, 91.4%, 91.4% for CESM, respectively. The positive predictive value was 66.6% for digital MMG and 78.5% for CESM. The negative predictive value (NPV) was 96.9% for the CESM and exceeded NPV of the digital MMG, which was 93.7%.Conclusion. Thus, these findings suggest that CESM is an effective method for the diagnostics of malignant tumors in the breast.


Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 148
Author(s):  
Jonathan Cohen ◽  
Iben Riishede ◽  
Jonathan Frederik Carlsen ◽  
Trine-Lise Lambine ◽  
Mikkel Seidelin Dam ◽  
...  

This study aims to investigate the ability of ultrasound strain elastography as an adjunct to predict malignancy in soft tissue tumors suspect of sarcoma or metastasis in a tertiary reference center for sarcoma. A total of 137 patients were included prospectively. Patients were referred on the basis of clinical or radiological suspicion of malignant soft tissue tumor. All patients had previously undergone diagnostic imaging (MRI, CT or PET-CT). After recording strain elastography cine loops, ultrasound guided biopsy was performed. Three investigators, who were blinded to final diagnosis, reviewed all elastograms retrospectively. For each elastogram, a qualitative, visual 5-point score was decided in consensus and a strain ratio was calculated. Final pathology obtained from biopsy or tumor resection served as gold standard. Eighty-one tumors were benign, and 56 were malignant. t-tests showed a significant difference in mean visual score between benign and malignant tumors. There was no significant difference in mean strain ratio between the two groups. Strain elastography may be a valuable adjunct to conventional B-mode ultrasound, perhaps primarily in primary care, when considering whether to refer to a sarcoma center or to biopsy, although biopsies cannot reliably be ruled out based on the current data.


1994 ◽  
Vol 35 (4) ◽  
pp. 367-370 ◽  
Author(s):  
J. Gelineck ◽  
J. Keller ◽  
O. Myhre Jensen ◽  
O. Steen Nielsen ◽  
T. Christensen

Large soft tissue tumors — 5 cm or greater — or deep-seated tumors have a greater risk of being malignant than smaller and superficially located tumors (9). In a period of 2 years 43 consecutive patients with lipomatous tumors 5 cm in diameter or greater were examined with MR imaging. The MR findings were correlated to histologic features and diagnosis. Twenty-six tumors were classic lipomas both on MR and at microscopy; 8 lipomas showed other features — some of them raising suspicion of malignancy at MR; all, however, were histologically benign. Nine tumors were considered malignant at MR imaging; all 9 proved to be malignant by microscopy.


2021 ◽  
pp. 4-5
Author(s):  
Shweta S Hattarkar

Peripheral primitive neuroectodermal tumors (pPNET) are a group of highly malignant tumors composed of small round cells of neuroetodermal origin that affect soft tissue and bone ,most commonly present in the thoracopulmonary region (Askin tumor), abdomen , pelvis and rarely in the head and neck. They usually present in the second decade of life, with slight male preponderance and account for 4-17% of all soft tissue tumors. Clinical symptoms depend on the site of presentation but invariably include pain and swelling of surrounding structure due to mass effect. Current recommendations advocate complete surgical resection whenever possible, adjuvant or neoadjuvant chemotherapy and radiotherapy. Here we present a 20 year old male patient who presented with chest pain and breathlessness and on investigation found to have an anterior mediastinal mass which further evaluation found to be a primitive neuroectodermal tumor


2019 ◽  
Vol 6 (4) ◽  
pp. 7-12
Author(s):  
Hossein Akbari Aghdam ◽  
◽  
Azin Mohammad-Salehi ◽  
Hamed i Zandi-esfahan ◽  
Mohsen Heidari ◽  
...  

Background: Primary malignant tumors, including rare tumors of the skeleton, are of concern. However, the unpredictable prognosis, morbidity, and mortality of these tumors have raised them as one of the health problems. Objectives: This study was designed to evaluate the epidemiological characteristics of these tumors in Isfahan province, Iran. Methods: In this cross-sectional study, 489 patients with malignant bone and soft tissue tumors were enrolled from 2006 to 2016. Their data were available in Isfahan medical centers, and their diagnostic biopsies from their hospitals’ records were examined. The data were statistically analyzed using SPSS. Results: The most common tumors were in the descending order: Osteosarcoma (15.1%), Ewing sarcoma (13.7%), chondrosarcoma (13.1%), fibrosarcoma and neurofibrosarcoma (10.8%), malignant fibrous histiocytoma (7.8%), synovial sarcoma (6.7%), liposarcoma (6.5%), dermatofibrosarcoma (3.3%), rhabdomyosarcoma (3.1%), and leiomyosarcoma (3.1%). Other sarcomas comprised 16.8%. The highest prevalence of tumors was in Isfahan city. Conclusion: This study was conducted for the first time in Isfahan Province to evaluate the epidemiological characteristics of malignant bone and soft tissue tumors. Our study results were similar to most studies conducted in different regions of the world. Considering the relatively high prevalence of malignant bone and soft tissue tumors in lower age groups, we recommend further studies in this area to manage this problem.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R Abdullah ◽  
L Abdelmonem ◽  
N Nasry ◽  
M Ayoub

Abstract Background Breast cancer in women is a major public health problem throughout the world, being the second most common cancer worldwide. Sonomammography has been always recommended as the basic breast imaging modality for early detection and diagnosis of breast cancer. Some malignant tumors have been missed, specially in dense breasts, and high false-negative rate have been reported. Contrast enhanced spectral mammography is a new modality, used to depict the tumor vascularity and neoangiogenesis; a classic sign of malignant tumors. Aim of Work The purpose of this study is to determine the added value of dual energy contrast mammography to sono-mammography in the assessment of suspicious breast lesions. Patients and Methods 36 patients were included in the study, referred from outpatient clinics in private settings and from Demerdash Hospitals. Contrast enhanced spectral mammography CESM was performed by using a digital mammography unit (Seno DS; GE, Buc, France) that had been adapted to obtain two images for each view: a low-energy image (below the k edge of iodine, 33.2 keV) and a high-energy image (above the k edge of iodine) at 45 to 49 kVp. Results: CEDM versus sonomammography shows p (0.021) value less than 0.05. Also the area under the ROC curve was higher for MX+CEDM (94.4%) than that was for sonomammography (63.8%) compared to pathology analysis with 100% sensitivity, 88.2 % specificity, 90.48 %PPV and 100 % NPV in diagnosis of suspicious lesions. Conclusion The diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma has proven to be superior to sonomammography alone. CEDM had a better diagnostic accuracy mainly due to improved positive and negative predictive values (Positive predictive value about 90.48, negative predictive value 100). The role of CEDM in detection of multifocal / multicentric carcinomas with particular interest for the assessment of the extent of disease specially in dense breasts is appreciated.


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