Key result
Solid nodular MRI enhancement in extremity liposarcoma is linked to high-grade myxoid tumors.
Why the study?
MRI features of extremity liposarcoma subtypes and their correlation with histopathology and clinical outcomes were not well described.
Does MRI help distinguish between extremity liposarcoma subtypes and predict histopathologic grade and metastatic pattern?
Observational (n=125)
Does MRI help distinguish between extremity liposarcoma subtypes and predict histopathologic grade and metastatic pattern?
MRI features can help distinguish between extremity liposarcoma subtypes and predict histopathologic grade and metastatic pattern in myxoid liposarcoma.
MRI features may differentiate LPS subtypes; leaves open prospective validation before guiding management.
OBJECTIVE: This study aimed to describe magnetic resonance imaging (MRI) features of extremity liposarcoma (LPS) subtypes, correlating with histopathology and clinical outcomes. METHODS: In this retrospective study, we included 125 patients (80 men, 45 women; mean age, 53 years) with extremity LPS [23 atypical lipomatous tumor (ALT), 9 dedifferentiated (DDLPS), 70 myxoid (MLPS), 23 pleomorphic (PLPS)]. Pretreatment MRI of primary tumors in 56 patients (10 ALT, 4 DDLPS, 28 MLPS, 14 PLPS) was reviewed. RESULTS: All subtypes were predominantly T1 isointense relative to skeletal muscle (DDLPS = 3/4, MLPS = 28/28, PLPS = 13/14) and T2 hyperintense (ALT = 10/10, DDLPS = 3/4, MLPS = 28/28, PLPS = 14/14) except for ALT which were T1 hyperintense (8/10). Within MLPS, high grade was associated with unencapsulated margins (P = 0.05) and solid, nodular enhancement (P < 0.0001). Peritumoral edema (P = 0.03) and T2 heterogeneity (P = 0.05) predicted pulmonary (rather than extrapulmonary) metastases in MLPS. Tumor subtype correlated with mortality (P = 0.04). CONCLUSIONS: The MRI features can help to distinguish between extremity LPS subtypes, and can predict histopathologic grade and metastatic pattern in myxoid LPS.
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Wortman et al. (2016) conducted an observational in Extremity liposarcoma (n=125). MRI features and tumor subtype was evaluated on Correlation of MRI features with histopathology and clinical outcomes. In patients with extremity liposarcoma, tumor subtype correlated with mortality (P=0.04), and MRI features like solid, nodular enhancement were associated with high-grade myxoid tumors (P<0.0001).
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