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Tang M, Huang R, Chen J, Sheng M, Zhang Z, Xing J, Guo L, Li Y. Clinical value of high-resolution dynamic contrast-enhanced (DCE) MRI in diagnosis of cutaneous squamous cell carcinoma. Skin Res Technol 2020; 27:511-520. [PMID: 33141995 DOI: 10.1111/srt.12978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND While uncomplicated cases of skin squamous cell carcinoma (cSCC) can be treated with surgery topical therapy alone, more objective and non-invasive examination methods are needed to guide clinicians to make more detailed biopsy and surgical plans for lesions with atypical or subcutaneous growth. High-resolution magnetic resonance imaging (HR-MRI) is a novel skin imaging method. MATERIALS AND METHODS Prospective collection of 19 patients with clinically suspected cSCC. All patients underwent high-resolution DCE-MRI using a 70-mm microscopy coil before operation. The imaging features and results of surgical pathology were recorded. Ktrans , Kep , Ve values, and the time-signal curve (TIC) types were determined using DCE images. RESULTS 16 cases of cSCC, 3 cases of acanthoma. The subcutaneous invasion of all lesions was clearly displayed, of which 8 lesions invaded the subcutaneous fat layer, 5 invaded the muscle layer, 1 invaded the periosteum, 2 invaded the cap fascia, and the layer of all lesions invasion judged by HR-MR imaging was consistent with the postoperative pathology. The main manifestations of cSCC were ill-defined margin, obvious inhomogeneous enhancement, higher perfusion parameters value and type-III TIC, while acanthoma showed well-defined and type-I TIC. Some imaging findings (such as boundary, enhancement) and DCE perfusion parameters of the two groups overlap. CONCLUSION High-resolution DCE-MRI can fully and directly display the subcutaneous invasion of cSCC, and more work needs to be done to prove its value. Next, we will expand the sample size, and further explore its value in the differential diagnosis and prognosis evaluation of cSCC from acanthoma or other skin tumors.
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Affiliation(s)
- Mengxiao Tang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Renjun Huang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Jianhua Chen
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Meiying Sheng
- Department of Burn and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | | | - Jianming Xing
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Lingchuan Guo
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Yonggang Li
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
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Sheng M, Tang M, Lin W, Guo L, He W, Chen W, Li K, Liu J, Xiao C, Li Y. The value of preoperative high-resolution MRI with microscopy coil for facial nonmelanoma skin cancers. Skin Res Technol 2020; 27:62-69. [PMID: 32652773 DOI: 10.1111/srt.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The extent and depth of facial nonmelanoma skin cancers and the involvement of adjacent structures are critical features for surgical planning, but they are difficult to assess clinically. High-resolution MRI (HR-MRI) with microscopy coil may facilitate detailed evaluation of skin lesions. The authors performed this prospective study to determine the value of high-resolution microscopy coil MRI in the preoperative evaluation of nonmelanoma skin cancer. MATERIALS AND METHODS Between October 2018 and August 2019, 16 lesions from fifteen consecutive patients with facial nonmelanoma skin cancer were evaluated using high-resolution microscopy coil MRI about tumor extent, depth, margins, characteristic, and their spatial relationship with adjacent structures. The preoperative HR-MRI results were compared with the intraoperative findings and with the histopathology, with special note to the depth of invasion. RESULTS Among the 16 lesions, HR-MRI imaging was found to provide accurate evaluation of tumor extent, depth, and margins and determine whether there was involvement of adjacent structures. The tumor depth measured on HR-MRI showed good correlation with histopathologic results (CCC: 0.973), and Bland-Altman analysis finding no significant bias existed between the two measurements. All lesions except one were completely resected with primary excision. Only one lesion required further excision. During follow-up for 3-15 months, no tumor recurrence was observed in any case. CONCLUSIONS HR-MRI is an accurate, noninvasive imaging technique that can be used as preoperative evaluation tool for facial nonmelanoma skin cancer. It can accurate predict tumor depth, margins, and involvement of structure. The valuable information it provided facilitates surgeons optimize surgical planning.
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Affiliation(s)
- Meiying Sheng
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Mengxiao Tang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Wei Lin
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Lingchuan Guo
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Wenjun He
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Weixin Chen
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Ke Li
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Jianjiang Liu
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Can Xiao
- Department of Stomatology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
| | - Yonggang Li
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China
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Budak MJ, Weir-McCall JR, Yeap PM, White RD, Waugh SA, Sudarshan TAP, Zealley IA. High-Resolution Microscopy-Coil MR Imaging of Skin Tumors: Techniques and Novel Clinical Applications. Radiographics 2016; 35:1077-90. [PMID: 26172352 DOI: 10.1148/rg.2015140142] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
High-resolution magnetic resonance (MR) imaging performed with a microscopy coil is a robust radiologic tool for the evaluation of skin lesions. Microscopy-coil MR imaging uses a small surface coil and a 1.5-T or higher MR imaging system. Simple T1- and T2-weighted imaging protocols can be implemented to yield high-quality, high-spatial-resolution images that provide an excellent depiction of dermal anatomy. The primary application of microscopy-coil MR imaging is to delineate the deep margins of skin tumors, thereby providing a preoperative road map for dermatologic surgeons. This information is particularly useful for surgeons who perform Mohs micrographic surgery and in cases of nasofacial neoplasms, where the underlying anatomy is complex. Basal cell carcinoma is the most common nonmelanocytic skin tumor and has a predilection to manifest on the face, where it can be challenging to achieve complete surgical excision while preserving the cosmetic dignity of the patient. Microscopy-coil MR imaging provides dermatologic surgeons with valuable preoperative anatomic information that is not available at conventional clinical examination.
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Affiliation(s)
- Matthew J Budak
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Jonathan R Weir-McCall
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Phey M Yeap
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Richard D White
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Shelley A Waugh
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Thiru A P Sudarshan
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
| | - Ian A Zealley
- From the Departments of Clinical Radiology (M.J.B., J.R.W.M., P.M.Y., T.A.P.S., I.A.Z.) and Medical Physics (S.A.W.), Ninewells Hospital, Dundee, Scotland; and Department of Clinical Radiology, University Hospital of Wales, Cardiff, Wales (R.D.W.)
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Hayter CL, Linklater JM, Man KH. State of the Art MR Imaging Techniques for the Foot and Ankle. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0042-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Iwama Y, Kunisada M, Goto H, Ohno Y, Yamashita J, Funasaka Y, Nishigori C, Fujii M. Malignant peripheral nerve sheath tumor of the distal phalanx of the fifth toe: a case report. Acta Radiol Short Rep 2014; 3:2047981613516033. [PMID: 24778799 PMCID: PMC4001430 DOI: 10.1177/2047981613516033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 11/14/2013] [Indexed: 11/20/2022] Open
Abstract
Malignant peripheral nerve sheath tumor (MPNST) involving bone is rare. We report a case of MPNST of the fifth toe. The lesion was located in the distal phalanx of the right fifth toe and extended into surrounding subcutaneous tissues. Findings on magnetic resonance imaging and histological features of the case are described and the literature is briefly reviewed.
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Affiliation(s)
- Yuki Iwama
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makoto Kunisada
- Department of Dermatology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hajimu Goto
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junji Yamashita
- Department of Dermatology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoko Funasaka
- Department of Dermatology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chikako Nishigori
- Department of Dermatology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiko Fujii
- Department of Radiology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
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Nakayama-Takeda R, Sakakibara S, Kurokawa M, Hashikawa K, Terashi H. Comparison of Malignant Skin Tumor Thickness and Relative Depth of Invasion Estimates from Preoperative MR-Microscopy and Pathological Evaluation. Dermatol Surg 2013; 39:1767-73. [DOI: 10.1111/dsu.12371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Reiko Nakayama-Takeda
- Department of Plastic Surgery; Kobe University Graduate School of Medicine; Kobe Japan
| | - Shunsuke Sakakibara
- Department of Plastic Surgery; Kobe University Graduate School of Medicine; Kobe Japan
| | - Masato Kurokawa
- Department of Plastic and Reconstructive Surgery; Takarazuka City Hospital; Takarazuka City Japan
| | - Kazunobu Hashikawa
- Department of Plastic Surgery; Kobe University Graduate School of Medicine; Kobe Japan
| | - Hiroto Terashi
- Department of Plastic Surgery; Kobe University Graduate School of Medicine; Kobe Japan
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Langner I, Krüger PC, Evert K, Zach A, Hadlich S, Ekkernkamp A, Eisenschenk A, Hosten N, Langner S. MR microscopy of the human finger and correlation with histology-a proof-of-principle study. Clin Anat 2013; 26:719-27. [DOI: 10.1002/ca.22232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 12/28/2012] [Accepted: 01/21/2013] [Indexed: 12/16/2022]
Affiliation(s)
- I. Langner
- Zentrum fuer Handchirurgie; Abteilung für Unfall- und Wiederherstellungschirurgie; Universitaetsmedizin Greifswald; Germany
| | - P.-C. Krüger
- Institut fuer Diagnostische Radiologie und Neuroradiologie; Universitaetsmedizin Greifswald; Germany
| | - K. Evert
- Institut fuer Pathologie; Universitaet Greifswald; Germany
| | - A. Zach
- Zentrum fuer Handchirurgie; Abteilung für Unfall- und Wiederherstellungschirurgie; Universitaetsmedizin Greifswald; Germany
| | - S. Hadlich
- Institut fuer Diagnostische Radiologie und Neuroradiologie; Universitaetsmedizin Greifswald; Germany
| | - A. Ekkernkamp
- Zentrum fuer Handchirurgie; Abteilung für Unfall- und Wiederherstellungschirurgie; Universitaetsmedizin Greifswald; Germany
| | - A. Eisenschenk
- Zentrum fuer Handchirurgie; Abteilung für Unfall- und Wiederherstellungschirurgie; Universitaetsmedizin Greifswald; Germany
| | - N. Hosten
- Institut fuer Diagnostische Radiologie und Neuroradiologie; Universitaetsmedizin Greifswald; Germany
| | - S. Langner
- Institut fuer Diagnostische Radiologie und Neuroradiologie; Universitaetsmedizin Greifswald; Germany
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Kang Y, Choi JA, Chung JH, Hong SH, Kang HS. Accuracy of preoperative MRI with microscopy coil in evaluation of primary tumor thickness of malignant melanoma of the skin with histopathologic correlation. Korean J Radiol 2013; 14:287-93. [PMID: 23482432 PMCID: PMC3590342 DOI: 10.3348/kjr.2013.14.2.287] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/11/2012] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the accuracy of a preoperative MRI with microscopy coils in determining the primary tumor thickness of malignant melanoma with histopathologic correlation. MATERIALS AND METHODS Eleven patients with histopathologically confirmed malignant melanoma were included in this study. MR images of the tumors were obtained with a 47-mm microscopy coil on 1.5T MR scanners and were evaluated by two radiologists, who assessed the thickness of the primary tumor on T2-weighted images (T2WI) and gadolinium-enhanced T1-weighted images with fat suppression (Gd-T1WI) and compared the results with the histopathologic findings as the reference standard. Correlations between tumor thickness on MRI and histopathologic examination were assessed using concordance correlation coefficients (CCCs). Inter- and intraobserver variabilities of tumor measurements were also assessed by intraclass correlation coefficient (ICC). RESULTS Among the 11 cases included in the study, 10 cases from the same number of patients were managed with surgical excision and one case was confirmed with punch biopsy. The primary tumor thickness measured on T2WI showed better correlation with histopathologic results, as compared with measurements taken on Gd-T1WI: the CCC of measurements on T2WI ranged from 0.64 to 0.78, indicating a substantial agreement, whereas the CCC of measurements on Gd-T1WI ranged from 0.50 to 0.61, indicating a moderate to substantial agreement. Inter- and intraobserver agreements of readers 1 and 2 were excellent for both T2WI and Gd-T1WI, with ICC ranging from 0.86 to 0.99. CONCLUSION MR imaging with microscopy coils may be an accurate technique in the preoperative assessment of tumor thickness in malignant melanoma, especially on T2-weighted images.
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Affiliation(s)
- Yusuhn Kang
- Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea
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