How Effective Are Noninvasive Tests for Diagnosing Malignant Peripheral Nerve Sheath Tumors in Patients with Neurofibromatosis Type 1? Diagnosing MPNST in NF1 Patients

Table 2

Sensitivity, specificity, positive predictive values, and negative predictive values, along with their associated confidence intervals, for potential predictors of malignancy. These included tumor characteristics (depth relative to the fascia, and size > 5 cm in diameter), MRI findings (any necrosis, or necrosis >25% by volume), PET findings (SUV_max > 5, SUV peak > 4.5, and TLR > 3), and clinical findings (pain, enlarging, and nerve symptoms). Combinations of imaging findings (SUV_peak > or < 4.5 on PET and any or >25% necrosis on MRI) and clinical findings (1 of 3, 2 of 3, or 3 of 3 symptoms) are also included.

		Sensitivity	Specificity	PPV	NPV	Accuracy
Tumor characteristics	Deep	100.0 (88.0–100.0)	20.7 (8.7–40.3)	61.0 (47.4–73.2)	100.0 (51.7–100.0)	64.6
	Size > 5 cm	68.0 (46.4–84.2)	53.5 (34.2–72.0)	56.7 (37.7–74.0)	65.2 (42.8–82.8)	60.4
MRI findings	Necrosis (any)	87.5 (60.4–97.8)	76.1 (52.4–90.9)	51.4 (34.7–67.8)	73.7 (32.2–65.3)	81.1
	Necrosis (>25%)	75.0 (47.4–91.7)	95.2 (74.1–99.8)	92.3 (62.1–100)	83.3 (61.8–94.5)	86.5
PET findings	SUVmax > 5	89.3 (70.6–97.2)	73.3 (50.8–87.0)	75.8 (57.4–88.2)	88.0 (67.7–96.8)	78.0
	SUVpeak > 4.5	94.7 (71.9–99.7)	70.8 (48.8–86.6)	72.0 (50.4–87.1)	94.4 (70.6–99.7)	78.0
	TLR > 3	91.7 (71.5–98.5)	73.9 (51.3–88.90	78.6 (58.5–91.0)	89.5 (65.5–98.2)	82.1
	Visual score	94.1 (69.2–99.7)	70.8 (48.7–86.6)	69.6 (47.0–86.0)	94.4 (70.6–99.7)	80.5
Combined PET/MRI findings	SUVpeak > 4.5 (PET) or any necrosis (MRI)	95.5 (75.1–100)	66.7 (47.1–82.1)	67.7 (48.5–82.7)	95.2 (74.1–100)	78.8
	SUVpeak > 4.5 (PET) and any necrosis (MRI)	56.2 (30.6–79.2)	93.9 (78.4–98.9)	81.8 (47.8–96.8)	81.6 (65.1–91.7)	81.6
	SUVpeak > 4.5 (PET) or necrosis >25% (MRI)	72.2 (46.5–90.3)	50.0 (26.0–74.0)	60.1 (36.7–78.5)	64 (42.8–81.2)	61.1
	SUVpeak > 4.5 (PET) and necrosis >25% (MRI)	61.5 (31.6–86.14)	100 (81.5–100)	100 (59.8–100)	78.3 (64.4–87.6)	83.9
Clinical findings	Pain	85.2 (65.4–95.1)	28.1 (14.4–47.0)	50 (35.1–64.9)	69.2 (38.9–89.6)	54.2
	Growth	85.2 (65.4–95.1)	25.0 (12.1–43.8)	48.9 (34.3–63.7)	66.7 (35.4–88.7)	52.5
	Nerve symptoms	44.8 (26.9–64.0)	75.0 (57.5–87.3)	59.1 (36.7–78.5)	62.3 (46.7–76.6)	61.0
Combined clinical findings	1 of 3 findings	92.9 (75.0–98.8)	9.68 (2.53–26.9)	48.1 (34.5–62.0)	60.0 (17.0–92.7)	49.1
	2 of 3 findings	89.3 (70.6–97.2)	43.8 (26.8–62.1)	58.1 (42.2–72.6)	82.3 (55.8–95.3)	65.0
	3 of 3 findings	32.1 (16.6–5.24)	78.1 (60.0–90.1)	56.2 (30.6–79.2)	43.2 (28.7–58.9)	56.7