Diagnostic Performance of US and MRI in Predicting Malignancy of Soft Tissue Masses: Using a Scoring System.

To assess the diagnostic performance of US and MRI in predicting malignancy of soft tissue masses by using a scoring system. A total of 120 cases of pathologically confirmed soft tissue masses (71 cases of malignant lesions and 49 cases of benign lesions) were enrolled. All patients underwent ultrasound and MRI examination prior to biopsy or surgical excision. A scoring system based on the parameters of conventional US and MRI to distinguish malignant and benign masses was established by the regression model. The receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of US and MRI. Multivariate analysis showed that margin, maximum diameter, and vascular density were independent predictors for malignancy found by US, while maximum diameter, margin, and affected peripheral soft tissue were independent predictors for malignancy found by MRI. The mean scores of the benign and malignant groups were 2.8 ± 1.6, 5.1 ± 1.1 on US and 1.3 ± 1.2, 3.5 ± 0.9 on MRI. Based on the cut-off score of 3.5 and 2.5 calculated by ROC analysis, US and MRI had 92% and 87% sensitivity, 72% and 76% specificity, 86% and 89% accuracy, respectively. The combination of these two modalities achieved the sensitivity of 91%, specificity of 82%, and accuracy of 93%. Both US and MRI can provide valuable information about the differential diagnosis between benign and malignant soft tissue masses. The combination of the two imaging-based scoring systems can increase the diagnostic performance, especially in specificity.

Shu H ，Ma Q ，Li A ，Wang P ，Gao Y ，Yao Q ，Hu Y ，Ye X ... -  《Frontiers in Oncology》

Shear-Wave Elastography of Benign versus Malignant Musculoskeletal Soft-Tissue Masses: Comparison with Conventional US and MRI.

Tavare AN ，Alfuraih AM ，Hensor EMA ，Astrinakis E ，Gupta H ，Robinson P ... -  《-》

MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions.

Moulton JS ，Blebea JS ，Dunco DM ，Braley SE ，Bisset GS 3rd ，Emery KH ... -  《AMERICAN JOURNAL OF ROENTGENOLOGY》

Usefulness of diffusion-weighted MR imaging for differentiating between benign and malignant superficial soft tissue tumours and tumour-like lesions.

Jeon JY ，Chung HW ，Lee MH ，Lee SH ，Shin MJ ... -  《-》

Magnetic resonance scoring system for assessment of adnexal masses: added value of diffusion-weighted imaging including apparent diffusion coefficient map.

To validate prospectively the ADNEX magnetic resonance (MR) scoring system to assess adnexal masses and to evaluate a new, modified ADNEX MR scoring system that incorporates diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping. Between January 2015 and September 2018, 323 consecutive women with adnexal masses diagnosed on transvaginal ultrasound (TVS) underwent standardized MR imaging (MRI) including diffusion and dynamic contrast-enhanced sequences. Of these, 131 underwent subsequent surgery. For interpretation of the MRI examinations, we applied the five-category ADNEX MR scoring system, along with a modified scoring system including DWI with ADC mapping. For both scoring systems, a score was given for all adnexal masses. Histological diagnosis was considered as the gold standard and lesions were classified as benign or malignant. The difference between the predictive values for diagnosing malignancy of the classical and modified scoring systems was assessed on the basis of the areas under the receiver-operating-characteristics (AUC) curves. The sensitivity and specificity for diagnosing malignancy of each score were also calculated. Among the 131 women with adnexal mass(es) diagnosed on TVS who underwent MRI and subsequent surgery, the surgery revealed 161 adnexal masses in 126 women; five women had no mass. Histological examination confirmed 161 adnexal masses, of which all had been detected on MRI: 32 malignant tumors, 15 borderline tumors, which were classified as part of the malignant group (n = 47), and 114 benign lesions. The AUC for prediction of a malignant lesion was 0.938 (95% CI, 0.902-0.975) using the classical ADNEX MR scoring system and 0.974 (95% CI, 0.953-0.996) using the modified scoring system. Pairwise comparison of these AUCs revealed a significant difference (P = 0.0032). The sensitivity and specificity for diagnosing malignancy with an ADNEX MR score of 4 or more were 95.5% and 86.6%, respectively, using the classic scoring system, and 95.7% and 93.3%, respectively, using the modified scoring system. DWI with ADC mapping could be integrated into the ADNEX MR scoring system to improve specificity, thereby potentially optimizing clinical management by avoiding unnecessary surgery. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Hottat NA ，Van Pachterbeke C ，Vanden Houte K ，Denolin V ，Jani JC ，Cannie MM ... -  《-》