Primary pharyngeal synovial sarcoma in a pediatric patient: A case report

Abstract BackgroundSynovial sarcoma is a rare malignant tumor that typically originates from the soft tissue of the extremities. The occurrence of primary pharyngeal synovial sarcoma (PPSS) is even rarer, and few studies have reported its radiological features. Here, we report a case of pediatric PPSS and describe the conventional and advanced magnetic resonance imaging (MRI) findings with pathologic correlation.Case presentationAn 11-year-old girl presented to the otolaryngologic clinic with dysphagia. Laryngoscopy revealed a large mass in the oropharynx. MRI revealed a well-defined soft tissue mass with a maximal diameter of approximately 5 cm originating from the submucosal space of the oropharynx. The mass was primarily solid and showed homogeneous contrast-enhancement. The mass was hypointense on T1-weighted images and hyperintense on T2-weighted images. The mass showed a homogeneously low apparent diffusion coefficient value on diffusion-weighted imaging, which indicated high tumor cellularity. Dynamic contrast-enhanced MRI revealed a hypovascular tumor with low values of the volume transfer constant between the extracellular extravascular space and blood plasma and blood plasma volume per unit tissue volume. Amide proton transfer-weighted MRI revealed a relatively high amide proton transfer signal in the tumor, indicating a high protein/peptide component. The patient underwent surgical resection of the tumor, and the diagnosis of biphasic synovial sarcoma was confirmed on postoperative pathological examination. The patient was started on chemotherapy with vincristine, ifosfamide, doxorubicin, and etoposide, and the patient is still under follow-up.ConclusionSynovial sarcoma should be considered in the differential diagnosis of pediatric oropharyngeal submucosal tumors. Multimodal MRI may aid diagnosis, although the final diagnosis should be based on the postoperative pathological examination findings.

Download Full-text

Evaluation of amide proton transfer-weighted imaging for endometrial carcinoma histological features: a comparative study with diffusion kurtosis imaging

European Radiology ◽

10.1007/s00330-021-07966-y ◽

2021 ◽

Author(s):

Nan Meng ◽

Xuejia Wang ◽

Jing Sun ◽

Zhun Huang ◽

Zhen Yang ◽

...

Keyword(s):

Proton Transfer ◽

Comparative Study ◽

Endometrial Carcinoma ◽

Amide Proton ◽

Diffusion Kurtosis Imaging ◽

Histological Features ◽

Amide Proton Transfer ◽

Diffusion Kurtosis

Download Full-text

Amide proton transfer weighted (APTw) imaging based radiomics allows for the differentiation of gliomas from metastases

Scientific Reports ◽

10.1038/s41598-021-85168-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Elisabeth Sartoretti ◽

Thomas Sartoretti ◽

Michael Wyss ◽

Carolin Reischauer ◽

Luuk van Smoorenburg ◽

...

Keyword(s):

Machine Learning ◽

Random Forest ◽

Brain Tumors ◽

Proton Transfer ◽

Multilayer Perceptron ◽

Random Forest Classifier ◽

Amide Proton ◽

Low Grade ◽

Who Grade ◽

Amide Proton Transfer

AbstractWe sought to evaluate the utility of radiomics for Amide Proton Transfer weighted (APTw) imaging by assessing its value in differentiating brain metastases from high- and low grade glial brain tumors. We retrospectively identified 48 treatment-naïve patients (10 WHO grade 2, 1 WHO grade 3, 10 WHO grade 4 primary glial brain tumors and 27 metastases) with either primary glial brain tumors or metastases who had undergone APTw MR imaging. After image analysis with radiomics feature extraction and post-processing, machine learning algorithms (multilayer perceptron machine learning algorithm; random forest classifier) with stratified tenfold cross validation were trained on features and were used to differentiate the brain neoplasms. The multilayer perceptron achieved an AUC of 0.836 (receiver operating characteristic curve) in differentiating primary glial brain tumors from metastases. The random forest classifier achieved an AUC of 0.868 in differentiating WHO grade 4 from WHO grade 2/3 primary glial brain tumors. For the differentiation of WHO grade 4 tumors from grade 2/3 tumors and metastases an average AUC of 0.797 was achieved. Our results indicate that the use of radiomics for APTw imaging is feasible and the differentiation of primary glial brain tumors from metastases is achievable with a high degree of accuracy.

Download Full-text

Prediction of H3K27M-mutant brainstem glioma by amide proton transfer–weighted imaging and its derived radiomics

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05455-4 ◽

2021 ◽

Author(s):

Zhizheng Zhuo ◽

Liying Qu ◽

Peng Zhang ◽

Yunyun Duan ◽

Dan Cheng ◽

...

Keyword(s):

Proton Transfer ◽

Brainstem Glioma ◽

Amide Proton ◽

Amide Proton Transfer

Download Full-text

Amide proton transfer imaging for differentiation of tuberculomas from high-grade gliomas: Preliminary experience

The Neuroradiology Journal ◽

10.1177/19714009211002766 ◽

2021 ◽

pp. 197140092110027

Author(s):

Karthik Kulanthaivelu ◽

Shumyla Jabeen ◽

Jitender Saini ◽

Sanita Raju ◽

Atchayaram Nalini ◽

...

Keyword(s):

Proton Transfer ◽

Chemical Exchange ◽

Spin Echo ◽

Chemical Exchange Saturation Transfer ◽

Amide Proton ◽

High Grade ◽

Saturation Pulse ◽

Amide Proton Transfer ◽

High Grade Gliomas ◽

Amide Protons

Purpose Tuberculomas can occasionally masquerade as high-grade gliomas (HGG). Evidence from magnetisation transfer (MT) imaging suggests that there is lower protein content in the tuberculoma microenvironment. Building on the principles of chemical exchange saturation transfer and MT, amide proton transfer (APT) imaging generates tissue contrast as a function of the mobile amide protons in tissue’s native peptides and intracellular proteins. This study aimed to further the understanding of tuberculomas using APT and to compare it with HGG. Method Twenty-two patients ( n = 8 tuberculoma; n = 14 HGG) were included in the study. APT was a 3D turbo spin-echo Dixon sequence with inbuilt B0 correction. A two-second, 2 μT saturation pulse alternating over transmit channels was applied at ±3.5 ppm around water resonance. The APT-weighted image (APTw) was computed as the MT ratio asymmetry (MTRasym) at 3.5 ppm. Mean MTRasym values in regions of interest (areas = 9 mm2; positioned in component with homogeneous enhancement/least apparent diffusion coefficient) were used for the analysis. Results MTRasym values of tuberculomas ( n = 14; 8 cases) ranged from 1.34% to 3.11% ( M = 2.32 ± 0.50). HGG ( n = 17;14 cases) showed MTRasym ranging from 2.40% to 5.70% ( M = 4.32 ± 0.84). The inter-group difference in MTRasym was statistically significant ( p < 0.001). APTw images in tuberculomas were notable for high MTRasym values in the perilesional oedematous-appearing parenchyma (compared to contralateral white matter; p < 0.001). Conclusion Tuberculomas demonstrate lower MTRasym ratios compared to HGG, reflective of a relative paucity of mobile amide protons in the ambient microenvironment. Elevated MTRasym values in perilesional parenchyma in tuberculomas are a unique observation that may be a clue to the inflammatory milieu.

Download Full-text