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Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiation of soft tissue sarcoma from benign lesions: a systematic review of literature

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Abstract

Objective

To systematically review the literature assessing the role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the differentiation of soft tissue sarcomas from benign lesions.

Materials and methods

A comprehensive literature search was performed with the following keywords: multiparametric magnetic resonance imaging, DCE-MR perfusion, soft tissue, sarcoma, and neoplasm. Original studies evaluating the role of DCE-MRI for differentiating benign soft-tissue lesions from soft-tissue sarcomas were included.

Results

Eighteen studies with a total of 965 imaging examinations were identified. Ten of twelve studies evaluating qualitative parameters reported improvement in discriminative power. One of the evaluated qualitative parameters was time-intensity curves (TIC), and malignant curves (TIC III, IV) were found in 74% of sarcomas versus 26.5% benign lesions. Six of seven studies that used the semiquantitative approach found it relatively beneficial. Four studies assessed quantitative parameters including Ktrans (contrast transit from the vascular compartment to the interstitial compartment), Kep (contrast return to the vascular compartment), and Ve (the volume fraction of the extracellular extravascular space) in addition to other parameters. All found Ktrans, and 3 studies found Kep to be significantly different between sarcomas and benign lesions. The values for Ve were variable. Additionally, eight studies assessed diffusion-weighted imaging (DWI), and 6 of them found it useful.

Conclusion

Of different DCE-MRI approaches, qualitative parameters showed the best evidence in increasing the diagnostic performance of MRI. Semiquantitative and quantitative approaches seemed to improve the discriminative power of MRI, but which parameters and to what extent is still unclear and needs further investigation.

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Funding

Majid Chalian, M.D. received the RSNA R&E Scholar grant and Boeing Technology Development grant

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Authors and Affiliations

  1. Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA, 98105, USA

    Firoozeh Shomal Zadeh, Atefe Pooyan, Ehsan Alipour, Nastaran Hosseini, Peter C. Thurlow, Mehrzad Shafiei & Majid Chalian

  2. Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland

    Filippo Del Grande

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  1. Firoozeh Shomal Zadeh
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Shomal Zadeh, F., Pooyan, A., Alipour, E. et al. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiation of soft tissue sarcoma from benign lesions: a systematic review of literature. Skeletal Radiol 53, 1343–1357 (2024). https://doi.org/10.1007/s00256-024-04598-3

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