scholarly journals Can Strain Elastography Predict Malignancy of Soft Tissue Tumors in a Tertiary Sarcoma Center?

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 148
Author(s):  
Jonathan Cohen ◽  
Iben Riishede ◽  
Jonathan Frederik Carlsen ◽  
Trine-Lise Lambine ◽  
Mikkel Seidelin Dam ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Strain Ratio ◽  
Soft Tissue Tumors ◽  
Current Data ◽  
Strain Elastography ◽  
Valuable Adjunct ◽  
Malignant Soft Tissue Tumor ◽  
Significant Difference

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.

scholarly journals Significance of Coagulation and Fibrinolysis Markers for Benign and Malignant Soft Tissue Tumors

2020 ◽  
Author(s):  
Kunihiro Asanuma ◽  
Tomoki Nakamura ◽  
Tomohito Hagi ◽  
Takayuki Okamoto ◽  
Kouji Kita ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Characteristic Curve ◽  
Soft Tissue Tumors ◽  
Clinicopathological Parameters ◽  
Diagnostic Tools ◽  
Benign Tumors ◽  
Benign Soft Tissue Tumors ◽  
Significant Difference ◽  
Coagulation And Fibrinolysis

Abstract Background: The intimate relationship between coagulation and fibrinolysis in malignant tumors is a well-known phenomena, with the malignant phenotype enhancing coagulation and fibrinolysis. We hypothesized that soft tissue sarcoma (STS) affects the expression of coagulation and fibrinolysis markers, which could be used to distinguish STS from benign soft tissue tumors. We analyzed the correlations between plasma levels of D-dimer (DD), plasmin-α2 plasmin inhibitor complex (PIC), soluble fibrin (SF), and thrombin-antithrombin III complex (TAT) in benign soft tissue tumors and STS to elucidate whether these markers can be used to predict STS.Methods: Plasma DD, PIC, SF and TAT levels in primary soft tissue tumors (benign, 67, STS 68) were measured before biopsy or treatment. The marker levels were analyzed and compared to various clinicopathological parameters.Results: In malignancy (STS), the average DD, PIC and SF levels were significantly higher than in benign tumors. Multivariate logistic analysis of continuous variables indicated that only PIC exhibited a significant difference (OR: 24.5, 95%CI: 3.55-170, p=0.0012). Receiver operating characteristic curve analysis produced area under the curve values for DD: 0.691, PIC: 0.784, SF: 0.734 and TAT: 0.588. Youden’s index was used to establish thresholds of 0.37 (DD), 0.80 (PIC), 0.90 (SF) and 0.82 (TAT). Threshold values for PIC and SF indicated high specificity (0.881, 0.791) and high positive predictive value (0.818, 0.745), respectively The highest accuracy value among the markers was observed for PIC (0.704). Significant differences in multivariate analysis of binary variables were demonstrated by categorizing low and high groups based on their threshold, PIC (≥0.80) (OR: 3.36, 95%CI: 1.19-9.43, p=0.0212) and SF (≥0.90) (OR: 2.63, 95%CI: 1.04-6.66, p=0.0404) . Conclusions: Of the coagulation and fibrinolysis markers studied, increased PIC levels were related to STS and over 0.80 PIC was the most suitable for the prediction of STS, which, along with other diagnostic tools, represents a helpful subsidiary tool for the prediction of STS.

scholarly journals Radiomics of diffusion-weighted MRI compared to conventional measurement of apparent diffusion-coefficient for differentiation between benign and malignant soft tissue tumors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seung Eun Lee ◽  
Joon-Yong Jung ◽  
Yoonho Nam ◽  
So-Yeon Lee ◽  
Hyerim Park ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Diagnostic Value ◽  
Soft Tissue Tumors ◽  
Imaging Features ◽  
Malignant Soft Tissue Tumors ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Malignant Soft Tissue

AbstractDiffusion-weighted imaging (DWI) is proven useful to differentiate benign and malignant soft tissue tumors (STTs). Radiomics utilizing a vast array of extracted imaging features has a potential to uncover disease characteristics. We aim to assess radiomics using DWI can outperform the conventional DWI for STT differentiation. In 151 patients with 80 benign and 71 malignant tumors, ADCmean and ADCmin were measured on solid portion within the mass by two different readers. For radiomics approach, tumors were segmented and 100 original radiomic features were extracted on ADC map. Eight radiomics models were built with training set (n = 105), using combinations of 2 different algorithms—multivariate logistic regression (MLR) and random forest (RF)—and 4 different inputs: radiomics features (R), R + ADCmin (I), R + ADCmean (E), R + ADCmin and ADCmean (A). All models were validated with test set (n = 46), and AUCs of ADCmean, ADCmin, MLR-R, RF-R, MLR-I, RF-I, MLR-E, RF-E, MLR-A and RF-A models were 0.729, 0.753 0.698, 0.700, 0.773, 0.807, 0.762, 0.744, 0.773 and 0.807, respectively, without statistically significant difference. In conclusion, radiomics approach did not add diagnostic value to conventional ADC measurement for differentiating benign and malignant STTs.

scholarly journals Significance of coagulation and fibrinolysis markers for benign and malignant soft tissue tumors

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kunihiro Asanuma ◽  
Tomoki Nakamura ◽  
Tomohito Hagi ◽  
Takayuki Okamoto ◽  
Kouji Kita ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Characteristic Curve ◽  
Soft Tissue Tumors ◽  
Clinicopathological Parameters ◽  
Diagnostic Tools ◽  
Benign Tumors ◽  
Benign Soft Tissue Tumors ◽  
Significant Difference ◽  
Coagulation And Fibrinolysis

Abstract Background The intimate relationship between coagulation and fibrinolysis in malignant tumors is a well-known phenomena, with the malignant phenotype enhancing coagulation and fibrinolysis. We hypothesized that soft tissue sarcoma (STS) affects the expression of coagulation and fibrinolysis markers, which could be used to distinguish STS from benign soft tissue tumors. We analyzed the correlations between plasma levels of D-dimer (DD), plasmin-α2 plasmin inhibitor complex (PIC), soluble fibrin (SF), and thrombin-antithrombin III complex (TAT) in benign soft tissue tumors and STS to elucidate whether these markers can be used to predict STS. Methods Plasma DD, PIC, SF and TAT levels in primary soft tissue tumors (benign 67, STS 68) were measured before biopsy or treatment. The marker levels were analyzed and compared to various clinicopathological parameters. Results In malignancy (STS), the average DD, PIC and SF levels were significantly higher than in benign tumors. Multivariate logistic analysis of continuous variables indicated that only PIC exhibited a significant difference (OR: 24.5, 95%CI: 3.55–170, p = 0.0012). Receiver operating characteristic curve analysis produced area under the curve values for DD: 0.691, PIC: 0.784, SF: 0.734 and TAT: 0.588. Youden’s index was used to establish thresholds of 0.37 (DD), 0.80 (PIC), 0.90 (SF) and 0.82 (TAT). Threshold values for PIC and SF indicated high specificity (0.881, 0.791) and high positive predictive value (0.818, 0.745), respectively. The highest accuracy value among the markers was observed for PIC (0.704). Significant differences in multivariate analysis of binary variables were demonstrated by categorizing low and high groups based on their threshold, PIC (≥0.80) (OR: 3.36, 95%CI: 1.19–9.43, p = 0.0212) and SF (≥0.90) (OR: 2.63, 95%CI: 1.04–6.66, p = 0.0404) . Conclusions Of the coagulation and fibrinolysis markers studied, increased PIC levels were related to STS and over 0.80 PIC was the most suitable for the prediction of STS, which, along with other diagnostic tools, represents a helpful subsidiary tool for the prediction of STS.

scholarly journals Dose-Intensified Compared With Standard Chemotherapy for Nonmetastatic Ewing Sarcoma Family of Tumors: A Children's Oncology Group Study

2009 ◽  
Vol 27 (15) ◽  
pp. 2536-2541 ◽  
Author(s):  
Linda Granowetter ◽  
Richard Womer ◽  
Meenakshi Devidas ◽  
Mark Krailo ◽  
Chenguang Wang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Ewing Sarcoma ◽  
Malignant Tumors ◽  
Alkylating Agents ◽  
Survival Rates ◽  
Chromosomal Translocation ◽  
Soft Tissue Tumors ◽  
Standard Regimen ◽  
Significant Difference ◽  
Eligibility Requirements

Purpose The Ewing sarcoma family of tumors (ESFT) is a group of malignant tumors of soft tissue and bone sharing a chromosomal translocation affecting the EWS locus. The Intergroup INT-0091 demonstrated the superiority of a regimen of vincristine, cyclophosphamide, doxorubicin (VDC), and dactinomycin alternating with ifosfamide and etoposide (IE) over VDC for patients with nonmetastatic ESFT of bone. The goal of this study was to determine whether a dose-intensified regimen of VDC alternating with IE would further improve the outcome for patients with nonmetastatic ESFT of bone or soft tissue. Methods Patients with previously untreated, nonmetastatic ESFT of bone or soft tissue were eligible. They were randomly assigned to receive standard doses of VDC/IE over 48 weeks or a dose-intensified regimen of VDC/IE over 30 weeks. Results Four hundred seventy-eight patients met eligibility requirements: 231 patients received the standard regimen; 247 patients received the intensified regimen. The 5-year event-free survival (EFS) and overall survival rates for all eligible patients were 71.1% (95% CI, 67.7% to 75.0%) and 78.6% (95% CI, 74.6% to 82.1%), respectively. There was no significant difference (P = .57) in EFS between patients treated with the standard (5-year EFS, 72.1%; 95% CI, 65.8% to 77.5%) or intensified regimen (5-year EFS, 70.1%; 63.9% to 75%). Patients with soft tissue tumors accounted for 20% of the study population; there was no difference in outcome between patients with soft tissue and bone primary sites. Conclusion Dose escalation of alkylating agents as tested in this trial did not improve the outcome for patients with nonmetastatic ESFT of bone or soft tissue.

scholarly journals Hand tumors: A review of 186 patients at a single institute

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199399
Author(s):  
Taketsugu Fujibuchi ◽  
Hiroshi Imai ◽  
Joji Miyawaki ◽  
Teruki Kidani ◽  
Hiroshi Kiyomatsu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Malignant Tumors ◽  
Proximal Phalanx ◽  
Delayed Diagnosis ◽  
Ring Finger ◽  
Soft Tissue Tumors ◽  
Body Parts ◽  
Maximal Diameter ◽  
Benign Soft Tissue Tumors

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.

scholarly journals Histopathological study of soft tissue tumours in a tertiary health centre in southern part of Assam

2021 ◽  
Vol 9 (11) ◽  
pp. 3391
Author(s):  
Khadija S. Tapadar ◽  
Manoj K. Deka ◽  
R. N. Chaubey ◽  
Shah A. Sheikh ◽  
Gargi R. Choudhury ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Soft Tissue Tumors ◽  
The Body ◽  
World Health ◽  
Vascular Tumors ◽  
Benign Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Pleomorphic Sarcoma ◽  
Younger Age

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.

Preoperative evaluation of intraoperative blood loss during malignant soft tissue tumor resection by ultrasonography

2018 ◽  
Vol 23 (2) ◽  
pp. 403-407 ◽  
Author(s):  
Takeshi Morii ◽  
Tomonori Kishino ◽  
Naoko Shimamori ◽  
Mitsue Motohashi ◽  
Hiroaki Ohnishi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Blood Loss ◽  
Soft Tissue Tumor ◽  
Preoperative Evaluation ◽  
Tumor Resection ◽  
Intraoperative Blood Loss ◽  
Tissue Tumor ◽  
Malignant Soft Tissue Tumor ◽  
Malignant Soft Tissue

scholarly journals Comparison of the SRmax, SRave, and color map of strain-elastography in differentiating malignant from benign breast lesions

2018 ◽  
Vol 60 (1) ◽  
pp. 28-34
Author(s):  
Jin Hee Moon ◽  
Sung Hye Koh ◽  
Sun-Young Park ◽  
Ji-Young Hwang ◽  
Ji Young Woo
Keyword(s):  
Statistical Significance ◽  
Roc Curves ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Strain Elastography ◽  
Average Value ◽  
Maximum Value ◽  
Significant Difference ◽  
Malignant Breast ◽  
Color Map

Background The maximum value of the strain ratio (SR) is a newly developed measure in strain-elastography. Purpose To prospectively compare the diagnostic performance of three different measures of strain-elastography, the maximum value of the SR (SRmax), the average value of the SR (SRave), and the color map, for differentiating benign and malignant breast lesions. Material and Methods We obtained the SRmax and SRave of 314 lesions from 290 patients with the tissue to nodule SR and color map using a five-degree scoring system. The diagnostic performances of the SRmax, SRave, and color map were compared after obtaining the area under the receiver operating characteristic (ROC) curves (AUCs) of each parameter. Results The AUC of the SRmax (0.7674) was larger than the AUCs of the SRave (0.7138) and color map (0.6324), with statistical significance ( P = 0.0383 for SRmax vs. SRave, P = 0.0000 for SRmax vs. color map). The AUC of the SRave was larger than that of the color map; however, there was no significant difference. The optimal cut-off point of the SRmax that balanced the sensitivity (91.12%) and specificity (50.81%) was 5.16. Conclusion The SRmax is a more reliable diagnostic tool than the SRave and color map for differentiating benign and malignant breast lesions.

scholarly journals Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses

2020 ◽  
Vol 17 (23) ◽  
pp. 8868
Author(s):  
Armanda De Marchi ◽  
Simona Pozza ◽  
Lorena Charrier ◽  
Filadelfo Cannone ◽  
Franco Cavallo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Univariate Analysis ◽  
Soft Tissue Tumors ◽  
Deep Fascia ◽  
Contrast Enhanced Ultrasound ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
Potentially Malignant ◽  
Sensitivity Specificity

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.

Combination chemotherapy using adriamycin, DTIC, cyclophosphamide, and actinomycin D for advanced soft tissue sarcomas: a randomized comparative trial. A phase III, Southwest Oncology Group Study (7613).

1987 ◽  
Vol 5 (6) ◽  
pp. 851-861 ◽  
Author(s):  
L H Baker ◽  
J Frank ◽  
G Fine ◽  
S P Balcerzak ◽  
R L Stephens ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Actinomycin D ◽  
Malignant Tumors ◽  
Soft Tissue Sarcomas ◽  
Comparative Trial ◽  
Phase Iii ◽  
Oncology Group ◽  
Southwest Oncology Group ◽  
Significant Difference

The term soft tissue sarcoma refers to a large variety of malignant tumors arising in extraskeletal connective tissues that connect, support, and surround discrete anatomic structures. All visceral organs also contain a connective stroma that can undergo malignant transformation. Because of the histological similarities of this group of tumors and their relative rarity, treatment prescriptions for patients that have disseminated disease are most often uniform. In this study, we asked the question whether adding a third drug (cyclophosphamide or actinomycin D) to Adriamycin (Adr [Adria Laboratories, Columbus, OH])-(3,3-dimethyl-1-triazeno)- imidazole-4-carboxamide (DTIC) would improve the response rate and/or survival. A unique feature of this cooperative group clinical trial was the mandatory pathology review of the histological material. All patients of the Southwest Oncology Group between June 1, 1976, and November 17, 1979, who had a biopsy-confirmed diagnosis of a soft tissue sarcoma with convincing clinical or biopsy-documented evidence of metastatic disease were eligible for the study. Patients were randomized to receive (1) Adr, 60 mg/m2 intravenously, day 1, and DTIC, 250 mg/m2 every 3 weeks (104 patients); (2) Adr and DTIC as in (1) and cyclophosphamide, 500 mg/m2, day 1 (112 patients); or (3) Adr and DTIC as in (1) and actinomycin D, 1.2 mg/m2, day 1, (119 patients). There was no statistically significant difference in response rates (33%, 34%, and 24%) (P = .25). Median durations of response were 31 weeks in the Adr-DTIC arm, 26 weeks in the cyclophosphamide-DTIC-Adr arm, and 23 weeks in the Adr-DTIC-Actinomycin D arm (P = .78). Median durations of survival were 37, 42, and 50 weeks, respectively. Again, no statistically significant differences were observed (P = .59). Toxicities from each of these treatment arms were formidable and were equivalent. Prognostic factor analysis showed a prognosis based on bone marrow reserve, sex, and pathology subtype favorable to patients.

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