title: Intra-Articular Synovial Sarcomas: Incidence and Differentiating Features from Localized Pigmented Villonodular Synovitis.
abstract: Purpose. To determine the incidence of intra-articular synovial sarcomas and investigate if any radiological variables can differentiate them from localized (unifocal) pigmented villonodular synovitis (PVNS) and if multivariate data analysis could be used as a complementary clinical tool. Methods. Magnetic resonance images and radiographs of 7 cases of intra-articular synovial sarcomas and 14 cases of localized PVNS were blindedly reviewed. Variables analyzed were size, extra-articular growth, tumor border, blooming, calcification, contrast media enhancement, effusion, bowl of grapes sign, triple signal intensity sign, synovial low signal intensity, synovitis, age, and gender. Univariate and multivariate data analysis, the method of partial least squares-discriminant analysis (PLS-DA), were used. Register data on all synovial sarcomas were extracted for comparison. Results. The incidence of intra-articular synovial sarcomas was 3%. PLS-DA showed that age, effusion, size, and gender were the most important factors for discrimination between sarcomas and localized PVNS. No sarcomas were misclassified as PVNS with PLS-DA, while some PVNS were misclassified as sarcomas. Conclusions. The most important variables in differentiating intra-articular sarcomas from localized PVNS were age, effusion, size, and gender. Multivariate data analysis can be helpful as additive information to avoid a biopsy, if the tumor is classified as most likely being PVNS.
authors.affiliation: Department of Radiology, Capio S:t Göran Hospital, S:t Göransplan 1, 112 81 Stockholm, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Nordemar
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, Karolinska Vägen 1, 171 76 Solna, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Öberg
authors.affiliation: Department of Orthopaedics, Karolinska University Hospital, Karolinska Vägen 1, 171 76 Solna, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Brosjö
authors.affiliation: Department of Radiology, Karolinska University Hospital, Karolinska Vägen 1, 171 76 Solna, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Solnavägen 1, 171 77 Solna, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Skorpil
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