Focus on the Tumour Periphery in MRI Evaluation of Soft Tissue Sarcoma: Infiltrative Growth Signifies Poor Prognosis

Fernebro, Josefin; Wiklund, Marie; Jonsson, Kjell; Bendahl, Pär-Ola; Rydholm, Anders; Nilbert, Mef; Engellau, Jacob

doi:https://doi.org/10.1155/SRCM/2006/21251

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Clinical Study | Open Access

Volume 2006 | Article ID 021251 | https://doi.org/10.1155/SRCM/2006/21251

Focus on the Tumour Periphery in MRI Evaluation of Soft Tissue Sarcoma: Infiltrative Growth Signifies Poor Prognosis

Josefin Fernebro,¹Marie Wiklund,²Kjell Jonsson,²Pär-Ola Bendahl,¹Anders Rydholm,³Mef Nilbert,¹and Jacob Engellau¹

Received25 Jun 2006

Revised18 Sept 2006

Accepted01 Oct 2006

Published05 Dec 2006

Abstract

Purpose. Infiltrative microscopical peripheral growth of soft tissue sarcomas (STS) has been shown to be of prognostic importance and preoperative risk stratification could individualize neoadjuvant treatment. Patients and methods. We assessed peripheral tumour growth pattern on preoperative MRI from 78 STS. The findings were correlated to histopathology and to outcome. Results. The MRI-based peripheral tumour growth pattern was classified as pushing in 34 tumours, focally infiltrative in 25, and diffusely infiltrative in 19. All tumours with diffuse infiltration on MRI also showed microscopical infiltration, whereas MRI failed to identify infiltration in two-thirds of the microscopically infiltrative tumours. Diffusely infiltrative growth on MRI gave a 2.5 times increased risk of metastases (P=.01) and a 3.7 times higher risk of local recurrence (P=.02). Discussion. Based on this observation we suggest that MRI evaluation of STS should focus on the peripheral tumour growth pattern since it adds prognostic information of value for decisions on neoadjuvant therapies.

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Copyright

Copyright © 2006 Josefin Fernebro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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