1
|
Kawaguchi M, Kato H, Kobayashi K, Miyazaki T, Nagano A, Noda Y, Hyodo F, Matsuo M. Differences in MRI findings of superficial spindle cell lipoma and atypical lipomatous tumor/well-differentiated liposarcoma. Br J Radiol 2023; 96:20220743. [PMID: 36607278 PMCID: PMC9975377 DOI: 10.1259/bjr.20220743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of using MRI findings to differentiate superficial spindle cell lipomas (SCLs) from atypical lipomatous tumor/well-differentiated liposarcomas (ALT/WDLs). METHODS This study included 12 patients with histopathologically proven superficial SCLs and 11 with ALT/WDLs. MRI findings for both pathologies were retrospectively reviewed and compared between the two pathologies. RESULTS The neck, upper back, and shoulder regions were more frequent locations of SCLs than of ALT/WDLs (100% vs 55%, p < 0.05), whereas no significant differences were observed in age and sex. The median maximum diameter of the lesion was smaller in SCLs than in ALT/WDLs (44 mm [interquartile range (IQR): 35-63] vs 102 mm [IQR: 86-119], p < 0.05). On T 1 weighted images, non-fatty area was more frequently observed in SCLs than in ALT/WDLs (73% vs 25%, p < 0.05), and the median rate of non-fatty area was larger in SCLs than in ALT/WDLs (7.5% [IQR: 1.0-53] vs 0% [IQR: 0-0.2], p < 0.05). On fat-suppressed T 2 weighted images, a solid hyperintense area was more frequently observed in SCLs than in ALT/WDLs (83% vs 27%, p < 0.05). CONCLUSION The maximum diameter, non-fatty area on T 1 weighted images, and solid hyperintense area on fat-suppressed T 2 weighted images were useful imaging features for differentiating superficial SCLs from ALT/WDLs. ADVANCES IN KNOWLEDGE In superficial lipomatous tumors, small tumor size and non-fatty solid area were valuable findings for diagnosing SCLs.
Collapse
Affiliation(s)
| | - Hiroki Kato
- Department of Radiology, Gifu University, Gifu, Japan
| | | | | | - Akihito Nagano
- Department of Orthopedic Surgery, Gifu University, Gifu, Japan
| | | | - Fuminori Hyodo
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
| | | |
Collapse
|
2
|
Yoshida K, Nakamura T, Nakamura K, Matsuyama Y, Hagi T, Asanuma K, Sudo A. The Characteristics of magnetic resonance imaging and immunohistochemical findings in de-differentiated liposarcoma. J Orthop Surg (Hong Kong) 2023; 31:10225536231151519. [PMID: 36728750 DOI: 10.1177/10225536231151519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Radiological imaging in Dedifferentiated liposarcoma (DDLPS) often shows the coexistence of fatty and non-fatty solid components; however, it has been shown that when fatty components were not identified on magnetic resonance imaging (MRI), the diagnosis of DDLPS would not have been diagnosed if immunohistochemical (IHC) staining had not been performed. The aim of this study was to investigate the pattern of MRI and relationship between MRI and IHC findings in DDLPS. METHODS We retrospectively reviewed the cases of 25 patients with DDLPS. To identify the MRI spectrum of DDLPS, tumors were classified into the following four categories based on MRI findings: I = a well-defined fatty mass and juxtaposed well-defined non-fatty mass, II = a non-fatty component within a predominantly fatty mass, III = a focal fatty component within a large non-fatty mass, and IV = a non-fatty mass with atypical MRI findings. IHC staining for CDK4, MDM2, and p16 were evaluated. RESULTS Category IV tumor was the most common tumor in this population. Of the 22 patients who underwent IHC staining, MDM2, CDK4, and p16 were positive in 21, 20, and 19 patients, respectively. MDM2 was positive in all 11 patients with category IV tumors; CDK4 and p 16 were positive in 10 and eight patients, respectively. There was no difference of survival between the patients with category I, II and III and category IV. CONCLUSIONS DDLPS without fatty components on MRI scans was mostly found. We recommend IHC staining to screen for DDLPS even if the tumors in STS cases have a non-fatty component.
Collapse
Affiliation(s)
- Keisuke Yoshida
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tomoki Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Koichi Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yumi Matsuyama
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tomohito Hagi
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kunihiro Asanuma
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akihiro Sudo
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| |
Collapse
|
3
|
Kawaguchi M, Kato H, Kobayashi K, Miyazaki T, Nagano A, Noda Y, Hyodo F, Matsuo M. MRI findings to differentiate musculoskeletal dedifferentiated liposarcoma from atypical lipomatous tumor. LA RADIOLOGIA MEDICA 2022; 127:1383-1389. [PMID: 36350422 DOI: 10.1007/s11547-022-01547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/18/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aimed to assess the efficacy of using MRI findings for differentiating musculoskeletal dedifferentiated liposarcoma (DDLP) from atypical lipomatous tumor (ALT). MATERIALS AND METHODS This study included 22 patients with histopathologically proven DDLP and 35 with ALT in the musculoskeletal areas. All DDLPs were immunohistochemically positive for MDM2. MRI findings for both pathologies were retrospectively reviewed and compared. RESULTS The maximum lesion diameter was significantly lower in DDLPs than in ALTs (p < 0.01). Ill-defined margin, peritumoral edema, and tail sign were more frequently observed in DDLPs than in ALTs (p < 0.01, respectively). The fatty component was less frequently observed in DDLPs than in ALTs (27 vs. 100%; p < 0.01), whereas the non-fatty component was more frequently observed in DDLPs than in ALTs (100 vs. 11%; p < 0.01). The occupation rate by non-fatty components was significantly higher in DDLPs than in ALTs (p < 0.01). No significant differences were observed in imaging findings associated with fatty component; however, necrosis within the non-fatty component on the contrast-enhanced image was more frequently observed in DDLPs than in ALTs (72 vs. 0%, p < 0.05). CONCLUSION DDLPs always had a non-fatty component, whereas ALTs always had fatty component. Ill-defined margin, peritumoral edema, tail sign, and necrosis within non-fatty components were useful MRI features for differentiating musculoskeletal DDLP from ALT.
Collapse
Affiliation(s)
- Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | | | | | - Akihito Nagano
- Department of Orthopedic Surgery, Gifu University, Gifu, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| |
Collapse
|
4
|
Vos M, Starmans MPA, Timbergen MJM, van der Voort SR, Padmos GA, Kessels W, Niessen WJ, van Leenders GJLH, Grünhagen DJ, Sleijfer S, Verhoef C, Klein S, Visser JJ. Radiomics approach to distinguish between well differentiated liposarcomas and lipomas on MRI. Br J Surg 2020; 106:1800-1809. [PMID: 31747074 PMCID: PMC6899528 DOI: 10.1002/bjs.11410] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/10/2019] [Accepted: 10/01/2019] [Indexed: 12/18/2022]
Abstract
Background Well differentiated liposarcoma (WDLPS) can be difficult to distinguish from lipoma. Currently, this distinction is made by testing for MDM2 amplification, which requires a biopsy. The aim of this study was to develop a noninvasive method to predict MDM2 amplification status using radiomics features derived from MRI. Methods Patients with an MDM2‐negative lipoma or MDM2‐positive WDLPS and a pretreatment T1‐weighted MRI scan who were referred to Erasmus MC between 2009 and 2018 were included. When available, other MRI sequences were included in the radiomics analysis. Features describing intensity, shape and texture were extracted from the tumour region. Classification was performed using various machine learning approaches. Evaluation was performed through a 100 times random‐split cross‐validation. The performance of the models was compared with the performance of three expert radiologists. Results The data set included 116 tumours (58 patients with lipoma, 58 with WDLPS) and originated from 41 different MRI scanners, resulting in wide heterogeneity in imaging hardware and acquisition protocols. The radiomics model based on T1 imaging features alone resulted in a mean area under the curve (AUC) of 0·83, sensitivity of 0·68 and specificity of 0·84. Adding the T2‐weighted imaging features in an explorative analysis improved the model to a mean AUC of 0·89, sensitivity of 0·74 and specificity of 0·88. The three radiologists scored an AUC of 0·74 and 0·72 and 0·61 respectively; a sensitivity of 0·74, 0·91 and 0·64; and a specificity of 0·55, 0·36 and 0·59. Conclusion Radiomics is a promising, non‐invasive method for differentiating between WDLPS and lipoma, outperforming the scores of the radiologists. Further optimization and validation is needed before introduction into clinical practice.
Collapse
Affiliation(s)
- M Vos
- Department of Medical, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.,Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M P A Starmans
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
| | - M J M Timbergen
- Department of Medical, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.,Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - S R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
| | - G A Padmos
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - W Kessels
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands.,Department of Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | - W J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands.,Department of Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | | | - D J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - S Sleijfer
- Department of Medical, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - C Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - S Klein
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
| | - J J Visser
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| |
Collapse
|