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Schmitz F, Sedaghat S. Diagnostic Value of Magnetic Resonance Imaging Radiomics and Machine-learning in Grading Soft Tissue Sarcoma: A Mini-review on the Current State. Acad Radiol 2024:S1076-6332(24)00598-1. [PMID: 39261231 DOI: 10.1016/j.acra.2024.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/15/2024] [Accepted: 08/17/2024] [Indexed: 09/13/2024]
Abstract
Soft tissue sarcomas (STS) are a heterogeneous group of rare malignant tumors. Tumor grade might be underestimated in biopsy due to intratumoral heterogeneity. This mini-review aims to present the current state of predicting malignancy grades of STS through radiomics, machine learning, and deep learning on magnetic resonance imaging (MRI). Several studies investigated various machine-learning and deep-learning approaches in T2-weighted (w) images, contrast-enhanced (CE) T1w images, and DWI/ADC maps with promising results. Combining semantic imaging features, radiomics features, and deep-learning signatures in machine-learning models has demonstrated superior predictive performances compared to individual feature sources. Furthermore, incorporating features from both tumor volume and peritumor region is beneficial. Especially random forest and support vector machine classifiers, often combined with the least absolute shrinkage and selection operator (LASSO) and/or synthetic minority oversampling technique (SMOTE), did show high area under the curve (AUC) values and accuracies in existing studies.
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Affiliation(s)
- Fabian Schmitz
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany (F.S., S.S.)
| | - Sam Sedaghat
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany (F.S., S.S.).
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Schmitz F, Sedaghat S. Inferring malignancy grade of soft tissue sarcomas from magnetic resonance imaging features: A systematic review. Eur J Radiol 2024; 177:111548. [PMID: 38852328 DOI: 10.1016/j.ejrad.2024.111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/22/2024] [Accepted: 06/02/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Systematic reviews on the grading of STS using MRI are lacking. This review analyses the role of different MRI features in inferring the histological grade of STS. MATERIALS AND METHODS A systematic review was conducted and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The electronic databases of PubMed/MEDLINE were systematically searched for literature addressing the correlation of MRI findings in soft tissue sarcoma with tumor grade. As keywords "MRI", "magnetic resonance imaging", "sarcoma", "grade", "grading", and "FNCLCC" have been selected. RESULTS 14 studies have been included in this systematic review. Tumor size (p = 0.015 (51 patients) to p = 0.81 (36 patients)), tumor margin (p < 0.001 (95 patients) to 0.93 (36 patients)), necrosis (p = 0.004 (50 patients) to p = 0.65 (95 patients)), peritumoral edema (p = 0.002 (130 patients) to p = 0.337 (40 patients)), contrast enhancement (p < 0.01 (50 patients) to 0.019 (51 patients)) and polycyclic/multilobulated tumor configuration (p = 0.008 (71 patients)) were significantly associated with STS malignancy grade in most of the included studies. Heterogeneity in T2w images (p = 0.003 (130 patients) to 0.202 (40 patients)), signal intensity in T1w images/ hemorrhage (p = 0.02 (130 patients) to 0.5 (31 patients)), peritumoral contrast enhancement (p < 0.001 (95 patients) to 0.253 (51 patients)) and tumoral diffusion restriction (p = 0.01 (51 patients) to 0.53 (52 patients)) were regarded as significantly associated with FNCLCC grade in some of the studies which investigated these features. Most other MRI features were not significant. CONCLUSION Several MRI features, such as tumor size, necrosis, peritumoral edema, peritumoral contrast enhancement, intratumoral contrast enhancement, and polycyclic/multilobulated tumor configuration may indicate the malignancy grade of STS. However, further studies are needed to gain consensus.
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Affiliation(s)
- Fabian Schmitz
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Sam Sedaghat
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
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Salimbene O, Viggiano D, Muratori F, Lo Piccolo R, Facchini F, Tamburini A, Campanacci DA, Voltolini L, Gonfiotti A. Primary Chest Wall Ewing Sarcoma: Treatment and Long-Term Results. Life (Basel) 2024; 14:766. [PMID: 38929749 PMCID: PMC11204814 DOI: 10.3390/life14060766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE The aim of the study is to evaluate early and long-term results of chest wall primary Ewing's sarcoma patients treated in the time period February 2000-February 2023 by a multidisciplinary approach. METHODS We retrospectively reviewed the medical records of patients who underwent chest wall resection for a primary tumor. Treatment approach, extent of resection, 30-day mortality, overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were analyzed. RESULTS Overall, n = 15 consecutive patients were treated for chest wall primary Ewing's sarcoma. A median of n = 3 ribs was resected with a median of n = 2 ribs adjacent to the lesion. Resections were extended to the adjacent structures in n = 5 patients (33.3%). In all cases, we performed a prosthetic reconstruction, associated with muscle flap (n = 10, 66.6%) or with rigid titanium bars and muscle flap (n = 6, 40%). A radical resection was accomplished in n = 13 patients (84.6%). The median surgical time was 310 ± 120 min; median hospitalization was 7.8 ± 1.9 days. Post-operative mortality was zero. We recorded n = 4 (30.7%) post-operative complication. The median follow-up (FU) was 26 months. Moreover, 5-year overall and event-free survival were 52% and 48%, respectively. CONCLUSIONS This case series confirms the benefit of the multidisciplinary approach for Ewing sarcomas in early and long-term results.
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Affiliation(s)
- Ottavia Salimbene
- Division of Thoracic Surgery, Careggi University Hospital, 50134 Florence, Italy (D.V.); (L.V.)
| | - Domenico Viggiano
- Division of Thoracic Surgery, Careggi University Hospital, 50134 Florence, Italy (D.V.); (L.V.)
| | - Francesco Muratori
- Division of Oncological Orthopedics, Careggi University Hospital, 50134 Florence, Italy; (F.M.); (D.A.C.)
| | - Roberto Lo Piccolo
- Division of Pediatric Surgery, Meyer University Hospital, 50139 Florence, Italy; (R.L.P.); (F.F.)
| | - Flavio Facchini
- Division of Pediatric Surgery, Meyer University Hospital, 50139 Florence, Italy; (R.L.P.); (F.F.)
| | - Angela Tamburini
- Division of Pediatric Oncology, Meyer University Hospital, 50139 Florence, Italy;
| | - Domenico Andrea Campanacci
- Division of Oncological Orthopedics, Careggi University Hospital, 50134 Florence, Italy; (F.M.); (D.A.C.)
| | - Luca Voltolini
- Division of Thoracic Surgery, Careggi University Hospital, 50134 Florence, Italy (D.V.); (L.V.)
| | - Alessandro Gonfiotti
- Division of Thoracic Surgery, Careggi University Hospital, 50134 Florence, Italy (D.V.); (L.V.)
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De Angelis R, Casale R, Coquelet N, Ikhlef S, Mokhtari A, Simoni P, Bali MA. The impact of radiomics in the management of soft tissue sarcoma. Discov Oncol 2024; 15:62. [PMID: 38441726 PMCID: PMC10914656 DOI: 10.1007/s12672-024-00908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION Soft tissue sarcomas (STSs) are rare malignancies. Pre-therapeutic tumour grading and assessment are crucial in making treatment decisions. Radiomics is a high-throughput method for analysing imaging data, providing quantitative information beyond expert assessment. This review highlights the role of radiomic texture analysis in STSs evaluation. MATERIALS AND METHODS We conducted a systematic review according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in PubMed/MEDLINE and Scopus using the search terms: 'radiomics [All Fields] AND ("soft tissue sarcoma" [All Fields] OR "soft tissue sarcomas" [All Fields])'. Only original articles, referring to humans, were included. RESULTS A preliminary search conducted on PubMed/MEDLINE and Scopus provided 74 and 93 studies respectively. Based on the previously described criteria, 49 papers were selected, with a publication range from July 2015 to June 2023. The main domains of interest were risk stratification, histological grading prediction, technical feasibility/reproductive aspects, treatment response. CONCLUSIONS With an increasing interest over the last years, the use of radiomics appears to have potential for assessing STSs from initial diagnosis to predicting treatment response. However, additional and extensive research is necessary to validate the effectiveness of radiomics parameters and to integrate them into a comprehensive decision support system.
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Affiliation(s)
- Riccardo De Angelis
- Institut Jules Bordet, Anderlecht, Belgium
- Université Libre de Bruxelles, Brussels, Belgium
| | - Roberto Casale
- Institut Jules Bordet, Anderlecht, Belgium.
- Université Libre de Bruxelles, Brussels, Belgium.
| | | | - Samia Ikhlef
- Institut Jules Bordet, Anderlecht, Belgium
- Université Libre de Bruxelles, Brussels, Belgium
| | - Ayoub Mokhtari
- Institut Jules Bordet, Anderlecht, Belgium.
- Université Libre de Bruxelles, Brussels, Belgium.
| | - Paolo Simoni
- Université Libre de Bruxelles, Brussels, Belgium
| | - Maria Antonietta Bali
- Institut Jules Bordet, Anderlecht, Belgium
- Université Libre de Bruxelles, Brussels, Belgium
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Liu J, Shafaat O, Bhadra S, Parnell C, Harris A, Summers RM. Improved subcutaneous edema segmentation on abdominal CT using a generated adipose tissue density prior. Int J Comput Assist Radiol Surg 2024; 19:443-448. [PMID: 38233598 PMCID: PMC10881596 DOI: 10.1007/s11548-023-03051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE Edema, or swelling, is a common symptom of kidney, heart, and liver disease. Volumetric edema measurement is potentially clinically useful. Edema can occur in various tissues. This work focuses on segmentation and volume measurement of one common site, subcutaneous adipose tissue. METHODS The density distributions of edema and subcutaneous adipose tissue are represented as a two-class Gaussian mixture model (GMM). In previous work, edema regions were segmented by selecting voxels with density values within the edema density distribution. This work improves upon the prior work by generating an adipose tissue mask without edema through a conditional generative adversarial network. The density distribution of the generated mask was imported into a Chan-Vese level set framework. Edema and subcutaneous adipose tissue are separated by iteratively updating their respective density distributions. RESULTS Validation results on 25 patients with edema showed that the segmentation accuracy significantly improved. Compared to GMM, the average Dice Similarity Coefficient increased from 56.0 to 61.7% ([Formula: see text]) and the relative volume difference decreased from 36.5 to 30.2% ([Formula: see text]). CONCLUSION The generated adipose tissue density prior improved edema segmentation accuracy. Accurate edema volume measurement may prove clinically useful.
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Affiliation(s)
- Jianfei Liu
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Omid Shafaat
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sayantan Bhadra
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Christopher Parnell
- Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
| | - Ayden Harris
- Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
| | - Ronald M Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
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Choi JH, Choi Y, Lee KS, Ahn KH, Jang WY. Explainable Model Using Shapley Additive Explanations Approach on Wound Infection after Wide Soft Tissue Sarcoma Resection: "Big Data" Analysis Based on Health Insurance Review and Assessment Service Hub. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:327. [PMID: 38399614 PMCID: PMC10890019 DOI: 10.3390/medicina60020327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Soft tissue sarcomas represent a heterogeneous group of malignant mesenchymal tissues. Despite their low prevalence, soft tissue sarcomas present clinical challenges for orthopedic surgeons owing to their aggressive nature, and perioperative wound infections. However, the low prevalence of soft tissue sarcomas has hindered the availability of large-scale studies. This study aimed to analyze wound infections after wide resection in patients with soft tissue sarcomas by employing big data analytics from the Hub of the Health Insurance Review and Assessment Service (HIRA). Materials and Methods: Patients who underwent wide excision of soft tissue sarcomas between 2010 and 2021 were included. Data were collected from the HIRA database of approximately 50 million individuals' information in the Republic of Korea. The data collected included demographic information, diagnoses, prescribed medications, and surgical procedures. Random forest has been used to analyze the major associated determinants. A total of 10,906 observations with complete data were divided into training and validation sets in an 80:20 ratio (8773 vs. 2193 cases). Random forest permutation importance was employed to identify the major predictors of infection and Shapley Additive Explanations (SHAP) values were derived to analyze the directions of associations with predictors. Results: A total of 10,969 patients who underwent wide excision of soft tissue sarcomas were included. Among the study population, 886 (8.08%) patients had post-operative infections requiring surgery. The overall transfusion rate for wide excision was 20.67% (2267 patients). Risk factors among the comorbidities of each patient with wound infection were analyzed and dependence plots of individual features were visualized. The transfusion dependence plot reveals a distinctive pattern, with SHAP values displaying a negative trend for individuals without blood transfusions and a positive trend for those who received blood transfusions, emphasizing the substantial impact of blood transfusions on the likelihood of wound infection. Conclusions: Using the machine learning random forest model and the SHAP values, the perioperative transfusion, male sex, old age, and low SES were important features of wound infection in soft-tissue sarcoma patients.
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Affiliation(s)
- Ji-Hye Choi
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
- Anam Hospital Bloodless Medicine Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Yumin Choi
- School of Mechanical Engineering, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Kwang-Sig Lee
- AI Center, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Ki-Hoon Ahn
- Anam Hospital Bloodless Medicine Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
- Department of Obstetrics and Gynecology, Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Woo Young Jang
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;
- Anam Hospital Bloodless Medicine Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
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Andryk LM, Neilson JC, Wooldridge AN, Hackbarth DA, Bedi M, Baynes KE, LoGiudice JA, Slusarczyk SM, King DM. Outcomes and complications of postoperative seroma cavities following soft-tissue sarcoma resection. Front Oncol 2024; 14:1250069. [PMID: 38357208 PMCID: PMC10864592 DOI: 10.3389/fonc.2024.1250069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Seroma development is a known complication following extremity and trunk soft-tissue sarcoma (STS) resection. The purpose of this study is to evaluate and characterize seroma outcomes and the development of associated complications. Methods A retrospective review of 123 patients who developed postoperative seromas following STS resection at a single institution was performed. Various patient and surgical factors were analyzed to determine their effect on overall seroma outcomes. Results 77/123 seromas (62.6%) were uncomplicated, 30/123 (24.4%) developed infection, and 16/123 (13.0%) were symptomatic and required aspiration or drainage for symptom relief at an average of 12.2 months postoperatively. 65/123 (52.8%) seromas resolved spontaneously at an average time of 12.41 months. Seromas in the lower extremity (p=0.028), surgical resection volume >864 cm3, (p=<0.001) and initial seroma volume >42 cm3 (p=<0.001) increased the likelihood of infection. 90% of infected seromas developed the infection within the first three months following initial resection. No seromas which were aspirated or drained ultimately developed an infection following these procedures, though 50% recurred. Discussion Most seromas following STS resection are uncomplicated and do not require intervention, though a large resection cavity >864 cm3 and a large seroma volume >42 cm3 are risk factors for complications.
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Affiliation(s)
- Logan M. Andryk
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - John C. Neilson
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Adam N. Wooldridge
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Donald A. Hackbarth
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Meena Bedi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Keith E. Baynes
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - John A. LoGiudice
- Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sonia M. Slusarczyk
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - David M. King
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
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Casale R, De Angelis R, Coquelet N, Mokhtari A, Bali MA. The Impact of Edema on MRI Radiomics for the Prediction of Lung Metastasis in Soft Tissue Sarcoma. Diagnostics (Basel) 2023; 13:3134. [PMID: 37835878 PMCID: PMC10572878 DOI: 10.3390/diagnostics13193134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/03/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate whether radiomic features extracted solely from the edema of soft tissue sarcomas (STS) could predict the occurrence of lung metastasis in comparison with features extracted solely from the tumoral mass. MATERIALS AND METHODS We retrospectively analyzed magnetic resonance imaging (MRI) scans of 32 STSs, including 14 with lung metastasis and 18 without. A segmentation of the tumor mass and edema was assessed for each MRI examination. A total of 107 radiomic features were extracted for each mass segmentation and 107 radiomic features for each edema segmentation. A two-step feature selection process was applied. Two predictive features for the development of lung metastasis were selected from the mass-related features, as well as two predictive features from the edema-related features. Two Random Forest models were created based on these selected features; 100 random subsampling runs were performed. Key performance metrics, including accuracy and area under the ROC curve (AUC), were calculated, and the resulting accuracies were compared. RESULTS The model based on mass-related features achieved a median accuracy of 0.83 and a median AUC of 0.88, while the model based on edema-related features achieved a median accuracy of 0.75 and a median AUC of 0.79. A statistical analysis comparing the accuracies of the two models revealed no significant difference. CONCLUSION Both models showed promise in predicting the occurrence of lung metastasis in soft tissue sarcomas. These findings suggest that radiomic analysis of edema features can provide valuable insights into the prediction of lung metastasis in soft tissue sarcomas.
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Affiliation(s)
| | | | | | - Ayoub Mokhtari
- Institut Jules Bordet Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, 1070 Brussels, Belgium; (R.C.); (R.D.A.); (N.C.); (M.A.B.)
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Sedaghat S, Ravesh MS, Sedaghat M, Meschede J, Jansen O, Both M. Does the primary soft-tissue sarcoma configuration predict configuration of recurrent tumors on magnetic resonance imaging? Acta Radiol 2022; 63:642-651. [PMID: 33853376 DOI: 10.1177/02841851211008381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Soft-tissue sarcomas (STS) are rare malignancies of the soft tissue. PURPOSE To assess whether the magnetic resonance imaging (MRI) configuration of primary STS can predict the configuration of a recurring tumor and whether the MRI configuration of multiple recurrences differs in one and the same patient. MATERIAL AND METHODS Thirty-nine patients with histologically proven recurrent STS were included in this retrospective study and underwent pre- and post-treatment MRI. Three main configurations of primary and recurrent tumors were identified: polycyclic/multilobulated; ovoid/nodular; and streaky. RESULTS Sixty recurrent lesions were detected: 34 ovoid/nodular; 15 polycyclic/multilobulated; and 11 streaky. Five recurrences were multifocal and eight were bifocal. Of 39 patients, 28 (71.8%) presented one recurrence within the MRI follow-up period (P = 0.006); in 10 patients (25.6%), up to three different configurations of recurring STS were identified in one patient. Recurrences of polycyclic/multilobulated primaries were mostly ovoid/nodular (48%; P = 0.003) or polycyclic/multilobulated (37%; P = 0.014), and recurring ovoid/nodular STS significantly most often showed the same configuration as the primary tumor (85%; P < 0.001). Primary STS with a streaky configuration recurred in all three configurations in roughly equal proportions. Homogeneity/heterogeneity and tumor borders are significantly associated with the configuration of recurrences. CONCLUSION Primary STS configuration may help predict recurrent tumor configuration when the primary STS had a polycyclic/multilobulated or ovoid/nodular configuration. However, recurrent STS configuration can also differ from primary STS configuration, especially when the primary STS had a streaky configuration, rendering recurrent STS difficult to predict. Different configurations of recurrent STS in one and the same patient are common.
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Affiliation(s)
- Sam Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
- Institute of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Bergmannsheil, Bochum, Germany
| | - Mona Salehi Ravesh
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Maya Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
- Institute of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Bergmannsheil, Bochum, Germany
| | - Jens Meschede
- Institute of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Bergmannsheil, Bochum, Germany
- Department for Radiology and Neuroradiology, Klinikum Dortmund, Germany
| | - Olav Jansen
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Marcus Both
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
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Zhu T, Wang H, Jing Z, Fan D, Liu Z, Wang X, Tian Y. High efficacy of tetra-PEG hydrogel sealants for sutureless dural closure. Bioact Mater 2021; 8:12-19. [PMID: 34541383 PMCID: PMC8424082 DOI: 10.1016/j.bioactmat.2021.06.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/07/2021] [Accepted: 06/20/2021] [Indexed: 01/01/2023] Open
Abstract
Advances in meticulous dural closure technique remain a great challenge for watertight dural closure in the aged society, because the cerebrospinal fluid (CSF) leakage after spinal surgery is often accompanied with the disgusting wound infection, meningitis and pseudomeningocele. Here, a tetra-poly (ethylene glycol) (PEG)-based hydrogel sealant is developed with collective advantages of facile operation, high safety, quick set time, easy injectability, favorable mechanical strength and powerful tissue adhesion for effective sutureless dural closure during the surgery procedure. Impressively, this tetra-PEG sealant can instantaneously adhere to the irregular tissue surfaces even in a liquid environment, and effectively prevent or block off the intraoperative CSF leakage for sutureless dural closure and dura regeneration. Together, this sutureless tetra-PEG adhesive can be utilized as a very promising alternative for high-efficient watertight dural closure of the clinical patients who incidentally or deliberately undergo the durotomy during the spinal surgery.
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Affiliation(s)
- Tengjiao Zhu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Hufei Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zehao Jing
- Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Daoyang Fan
- Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Zhongjun Liu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yun Tian
- Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
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Sedaghat S, Sedaghat M, Krohn S, Jansen O, Freund K, Streitbürger A, Reichardt B. Long-term diagnostic value of MRI in detecting recurrent aggressive fibromatosis at two multidisciplinary sarcoma centers. Eur J Radiol 2020; 134:109406. [PMID: 33254066 DOI: 10.1016/j.ejrad.2020.109406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/02/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the diagnostic accuracy of MRI in detecting recurrent aggressive fibromatosis (AF) during long-term follow-up at two multidisciplinary sarcoma centers. METHODS Seventy-nine patients from two sarcoma centers were included in this IRB-approved study and were examined postoperatively using 1.5-T MRI. MRI follow-up scans were reviewed for true-positive/-negative and false-positive/-negative results. Available pathological reports and MRI follow-ups were set as reference. RESULTS The median age of the patients was 38.1 ± 15.3 years. Of the patients 27.9 % showed recurrent AF lesions. The most common localizations of AF were the axilla/shoulder (n = 15) and the thigh (n = 11). From 498 postoperative MRI follow-ups, 24 true-positive, 16 false-positive, 6 false-negative, and 452 true-negative MRI follow-ups were identified. The overall sensitivity and specificity for detecting recurrent AF was 80 % and 97 %, respectively. There was no significant difference in the diagnostic accuracy at the two sarcoma centers. All false-negative results were found in small lesions. False-positive results mostly mimicked streaky (n = 10) and small ovoid/nodular (n = 5) lesions. The configuration of recurrent AF was significantly most often fascicular (50 %; p = 0.001-0.005). CONCLUSION MRI shows a high long-term diagnostic value in detecting AF recurrences. Nevertheless, radiologists should pay close attention when lesions are small, as they may remain undetected. Although the configuration of recurrent AF is most often fascicular, recurrences may also appear in different shapes.
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Affiliation(s)
- Sam Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany; Institute of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Bergmannsheil, Bochum, Germany.
| | - Maya Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany; Institute of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Bergmannsheil, Bochum, Germany
| | - Sebastian Krohn
- Department of Prosthodontics, University Hospital Göttingen, Germany
| | - Olav Jansen
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Kai Freund
- Spinal Cord Injury Center, Clinic for Paraplegiologia and Neuro-Urology, Bad Berka, Germany
| | - Arne Streitbürger
- Department of Orthopedic Oncology, University Hospital Essen, Germany
| | - Benjamin Reichardt
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany; Department for Interventional Radiology and Neuroradiology, Klinikum Hochsauerland, Arnsberg, Germany
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