title: Correlation between preoperative magnetic resonance imaging and surgical margins with modified Mohs for dermatofibrosarcoma protuberans.
abstract: BACKGROUND
  Dermatofibrosarcoma protuberans (DFSP) is characterized by asymmetrical and poorly defined growth. Magnetic resonance imaging (MRI) has been proposed for the delimitation of this tumor.
  
  
  OBJECTIVE
  To study the utility of MRI in evaluating the depth of infiltration in DFSP and to compare the efficiency of clinical palpation with that of MRI in delimiting the invasiveness of DFSP.
  
  
  METHODS
  Observational, prospective study of DFSP cases. The MRI scans for all cases were compared with the exact histological infiltration plane obtained using modified Mohs micrographic surgery (MMS).
  
  
  RESULTS
  Forty-three DFSPs were included: 22 primary, nine recurrent, and 12 extirpated with positive margins. Sensitivity for detecting deep invasion was 58% on examination using palpation and 67% using MRI.
  
  
  CONCLUSIONS
  We present the largest series of DFSP cases studied using MRI published to date. In primary cases, MRI has greater sensitivity than palpation for detecting depth of infiltration (67% vs 58%). MRI seems to be useful in primary DFSP in locations other than the head, neck, and upper part of the thorax. MRI is not useful for confirming tumor persistence in extirpated DFSP with positive margins or for studying lateral extension in primary DFSP.
authors.affiliation: Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain. cserraguillen@gmail.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Serra-Guillén
authors.forename: Onofre
authors.initials: O
authors.lastname: Sanmartín
authors.forename: Beatriz
authors.initials: B
authors.lastname: Llombart
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nagore
authors.forename: Carlos
authors.initials: C
authors.lastname: Deltoro
authors.forename: Isabel
authors.initials: I
authors.lastname: Martín
authors.forename: Rafael
authors.initials: R
authors.lastname: Borella-Estrada
authors.forename: Celia
authors.initials: C
authors.lastname: Requena
authors.forename: Antonio
authors.initials: A
authors.lastname: Martorell-Calatayud
authors.forename: Jose
authors.initials: J
authors.lastname: Cervera
authors.forename: Carlos
authors.initials: C
authors.lastname: Guillén
mesh_terms: D018223:Dermatofibrosarcoma / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015580:Mohs Surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D057234:Preoperative Period; D011446:Prospective Studies; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D040521:Subcutaneous Tissue / Q000473:pathology