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Sarcoma
Volume 2006 (2006), Article ID 21251, 5 pages
http://dx.doi.org/10.1155/SRCM/2006/21251
Clinical Study

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

1Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, Lund 221 85, Sweden
2Department of Diagnostic Radiology, Institute of Clinical Sciences, Lund University Hospital, Lund 221 85, Sweden
3Department of Orthopedics, Institute of Clinical Sciences, Lund University Hospital, Lund 221 85, Sweden

Received 25 June 2006; Revised 18 September 2006; Accepted 1 October 2006

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.

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.