title: Whole-body magnetic resonance imaging in myxoid liposarcoma: A useful adjunct for the detection of extra-pulmonary metastatic disease.
abstract: Myxoid liposarcomas (MLS) are a subgroup of soft-tissue sarcomas which have a propensity for extra-pulmonary metastases. Conventional radiological staging of soft-tissue sarcomas consists of chest radiographs (CXR) and thoracic computed tomography (CT) for possible chest metastases, supplemented by magnetic resonance imaging (MRI) for local disease. The optimal radiological modality to detect extra-pulmonary metastases for systemic staging has not been proven. We reviewed the efficacy of Whole-Body MRI (WBMRI) for this purpose. 33 WBMRI and simultaneous CT scans were performed in 28 patients suffering from MLS between 2007 and 2015. 38 metastases were identified in seven patients via WBMRI. Osseous lesions predominated (spine, pelvis, chest-wall and long bones), followed by soft-tissue and abdominal lesions. Of the 29 soft-tissue or osseous metastases that were within the field-of-view of the simultaneous CT scans, five soft-tissue and zero osseous metastases were identified using CT. Metastatic disease was detected in three patients solely using WBMRI, which directly influenced their management. WBMRI is a useful adjunct in the detection of extra-pulmonary metastatic disease, which directly alters patient management. WBMRI has demonstrated an ability to identify more sites of metastatic disease compared to CT. WBMRI should be used in two situations. Firstly, at diagnosis where ablative treatment will be required e.g. amputation, when the diagnosis of occult metastasis would change treatment planning. Secondly, at diagnosis of relapse to confirm if it is a solitary site of relapse prior to consideration of metastectomy.
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Stevenson
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Orthopaedics, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Watson
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG, UK.
authors.forename: P
authors.initials: P
authors.lastname: Cool
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG, UK.
authors.forename: G L
authors.initials: GL
authors.lastname: Cribb
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Radiology, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
authors.forename: J P R
authors.initials: JP
authors.lastname: Jenkins
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Medical Oncology Department, The Christie NHS Foundation Trust, 550 Wilmslow Rd, Manchester, M20 4BX, UK.
authors.forename: M
authors.initials: M
authors.lastname: Leahy
authors.affiliation: Greater Manchester and Oswestry Sarcoma Service, Department of Orthopaedics, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK. Electronic address: jonathan.gregory2@nhs.net.
authors.forename: J J
authors.initials: JJ
authors.lastname: Gregory
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015203:Reproducibility of Results; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D051598:Whole Body Imaging / Q000379:methods*
keywords: MRI; Metastasis; Myxoid liposarcoma; Neoplasm staging; Sarcoma