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ECR 2019 / C-1792
Is MRI diffusion-weighted imaging a reliable tool for the diagnosis and post therapeutic follow up of extremity soft‑tissue neoplasms?
Congress: ECR 2019
Poster No.: C-1792
Type: Scientific Exhibit
Keywords: Musculoskeletal soft tissue, Oncology, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Neoplasia
Authors: A. F. I. Moustafa, R. A. Zeitoun, A. Shokry, M. M. A. Rezk; Cairo/EG

Methods and materials


The study population included 90 patients presenting with extremity soft tissue masses for an initial assessment at the National Cancer Institute in Egypt. The study has been approved by the ‘‘Ethical Committee of Faculty of Medicine, Cairo University”, in compliance with Helsinki Declaration. The patients’ ages range from 1 to 75 years with the mean age of 36 years. We performed a prospective lesion-based analysis for 108 newly diagnosed soft tissue lesions. We also include post-therapeutic imaging follow up for 18 patients.


Magnetic resonance imaging:


The patients had their MRI done on high field system (1.5 Tesla) closed magnet unit (Phillips Achieva XR) using the optimal surface coil to cover the examined area for each patient.


Imaging protocol:


All patient underwent a full MRI exam including conventional MRI sequences, DWI and Post Gadolinium DTPA MR imaging was performed. The DWI was obtained with 3 b values including 0, 400, and 800 s/mm².


Conventional MR imaging evaluation:


The morphological features of each lesion were recorded including signal characteristics and pattern of enhancement. The provisional diagnosis was reported. 


Diffusion-weighted imaging evaluation:


We reviewed the diffusion images with ADC values for final radiological characterization and detection of masses. The lesion was determined on DWI and ADC map by using the conventional MR images as a guide. Measurements were done via placing the region of interest (ROI) to include the largest area of the lesion. ADC of the minimum and mean values were obtained.


Statistical analysis:


Statistical analysis was performed using the statistical software (Med-calc). Numerical data were expressed as a mean and standard deviation or median and range as appropriate. Qualitative data were expressed as frequency and percentage.


ROC analysis (Receiver Operator Characteristic) was done to select the best cutoff point for ADC value. The findings on MRI were analyzed and correlated with histopathological findings after needle biopsy or resection or with previous imaging and investigations when available. A P value less than 0.05 was considered as statistically significant.


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