Musculoskeletal tumors: does fast dynamic contrast-enhanced subtraction MR imaging contribute to the characterization?
OBJECTIVE
To prospectively analyze the value of fast, dynamic, subtraction magnetic resonance (MR) imaging in the characterization of musculoskeletal tumors.


METHODS
In 175 consecutive patients with a musculoskeletal mass, dynamic contrast-enhanced subtraction MR imaging was performed after administration of 0.1 mmol per kilogram of body weight gadopentetate dimeglumine or gadoteridol. A turbo gradient-echo technique was used, with a temporal resolution of 1-3 seconds. The interval between arterial and early tumor enhancement, the pattern (peripheral or diffuse) of enhancement, and the progression of tumor enhancement, as visualized on time-signal intensity curves, were assessed. MR enhancement features were related to the histopathologic diagnoses.


RESULTS
Differentiation of benign from malignant soft-tissue masses was possible with a sensitivity of 91% and specificity of 72% based on start of enhancement, a sensitivity of 73% and specificity of 97% based on peripheral or diffuse enhancement, and a sensitivity of 86% and specificity of 81% based on progression of enhancement. Benign bone tumors could not be accurately differentiated from malignant bone tumors on the basis of the three defined parameters (sensitivity, 63%-76%; specificity, 50%-76%).


CONCLUSIONS
Dynamic, contract-enhanced, subtraction MR images may be useful to differentiate malignant from benign soft-tissue masses.
Department of Radiology, Leiden University Medical Center, The Netherlands.
H J
HJ
van der Woude
K L
KL
Verstraete
P C
PC
Hogendoorn
A H
AH
Taminiau
J
J
Hermans
J L
JL
Bloem
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis*; D001842:Bone and Bones / Q000473:pathology; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006571:Heterocyclic Compounds; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis*; D009132:Muscles / Q000473:pathology; D009942:Organometallic Compounds; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium; D019786:Gadolinium DTPA