title: Magnetic resonance imaging and positron emission tomography-computed tomography evaluation of soft tissue sarcoma with surgical and histopathological correlation.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) in characterization and pre-operative staging of soft-tissue sarcoma (STS) and correlating with operative and histopathological findings.
  
  
  METHODS
  Twenty patients (age range 16-72 years [mean 44.4 years]) with resectable and STS were included in this prospective study. Pre-operative MRI was carried out in all patients with acquisition of T1W, T2W, and short tau inversion recovery (STIR) sequences in appropriate planes. Contrast enhanced MRI was performed in four patients. Whole body PET-CT was performed in 13 patients. Demographic data, clinical features, pre-operative imaging analysis, operative, and histopathological findings were analyzed using SPSS software version 11.5.
  
  
  RESULTS
  The most common histologic type was malignant fibrous histiocytoma (MFH) (30%). Of 18 STSs 20 were high-grade. Agreement existed between MR and operative size. MRI had 100% negative predictive value (NPV) in predicting neurovascular bundle involvement. However, positive predictive value (PPV) was 33%. MRI had PPV of 20% while PET-CT had 50% PPV in detecting lymph node involvement. Overall staging accuracy of MRI was 75% when correlated with surgical and histopathological findings. Combined PET-CT and MRI staging, in 13 patients, was better (92.31%) when compared with staging with MRI (84.62%). Specific diagnosis on image characteristics was correctly suggested in 35% patients.
  
  
  CONCLUSIONS
  MRI is the robust modality in local staging of STSs and PET-CT adds greater accuracy to overall staging in combination with MRI.
authors.affiliation: Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Nauroze Asghar
authors.initials: NA
authors.lastname: Faizi
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thulkar
authors.forename: Raju
authors.initials: R
authors.lastname: Sharma
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Sh
authors.initials: Sh
authors.lastname: Chandrashekhara
authors.forename: Nootan Kumar
authors.initials: NK
authors.lastname: Shukla
authors.forename: Svs
authors.initials: S
authors.lastname: Deo
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
keywords: Magnetic resonance imaging; positron emission tomography-computed tomography; soft-tissue sarcoma; staging
references.citation: Radiology. 2007 Dec;245(3):839-47
references.pmid: 18024454
references.citation: Arch Surg. 1992 Nov;127(11):1285-9
references.pmid: 1444788
references.citation: Radiology. 1987 Jul;164(1):237-41
references.pmid: 3588912
references.citation: Ann Surg. 1987 Apr;205(4):340-8
references.pmid: 3032120
references.citation: Curr Opin Oncol. 2003 Jul;15(4):327-30
references.pmid: 12874512
references.citation: Eur J Radiol. 2005 Mar;53(3):500-5
references.pmid: 15741025
references.citation: Radiology. 1997 Jan;202(1):237-46
references.pmid: 8988217
references.citation: AJR Am J Roentgenol. 2000 Sep;175(3):575-87
references.pmid: 10954433
references.citation: Radiology. 2004 Nov;233(2):493-502
references.pmid: 15459325
references.citation: Rofo. 1992 Jun;156(6):587-91
references.pmid: 1617181
references.citation: AJR Am J Roentgenol. 1988 Mar;150(3):615-20
references.pmid: 3257620