Diagnostic Performances of Dynamic Contrast Enhanced Magnetic
Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses

Akansel, Gür; tosun, mesude; USLU, Hande; ANIK, YONCA; ÇİFTÇİ, ERCÜMENT

doi:10.5505/KTD.2021.46667

Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses

Hande USLU, (Kocaeli Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kocaeli, Türkiye)

Mesude TOSUN, (Kocaeli Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kocaeli, Türkiye)

Gür AKANSEL, (Kocaeli Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kocaeli, Türkiye)

Yonca ANIK, (Kocaeli Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kocaeli, Türkiye)

Ercüment ÇİFTÇİ (Kocaeli Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kocaeli, Türkiye)

Kocaeli Tıp Dergisi

4 0

Yıl: 2021 Cilt: 10 Sayı: 2 Sayfa Aralığı: 111 - 118 Metin Dili: İngilizce DOI: 10.5505/KTD.2021.46667 İndeks Tarihi: 11-06-2022

Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses

Öz:

INTRODUCTION: Our study aims to evaluate the diagnostic performances of Dynamic Contrast-En-hanced Magnetic Resonance Perfusion Imaging (DCE-MRPI) and T2 relaxation (T2 Mapping) parameters in the differentiation of benign and malignant soft tissue masses. METHODS: The study included 36 patients with 36 soft tissue masses (17 malignant and 19 benign). Imaging was performed using a 3 Tesla MRI, T2 perfusion and T2 relaxation studies were performed and Index, Negative Integral (NI), Mean Transit Time (MTT), Time to Peak (TTP), Time of Arrival (T0), and mean value of T2 relaxation time were calculated. Then, these parameters were compared between benign and malignant lesions. RESULTS: The differences of the maximum dimension of the lesions and NI values between benign and malignant masses were found statistically significant (p = 0.01 and p = 0.001 respectively). There was a statistically significant relationship between the presence of peritumoral edema and malignancy (p =0.05). DISCUSSION AND CONCLUSION: For the differentiation of benign from malignant soft tissue masses NI value may provide added information, when combined with conventional MRI and clinical findings. T2 relaxation times were not helpful in this regard due to significant overlap between benign and malig nant masses.

Anahtar Kelime:

Yumuşak Doku Kitlelerinde Kontrastlı Dinamik T2 Perfüzyon ve T2 Relaksometrinin Tanısal Performansı

Öz:

GİRİŞ ve AMAÇ: Dinamik Kontrastlı Manyetik Rezonans Perfüzyon görüntüleme (DK-MRPG) ve T2 relaksometri parametrelerinin yumuşak dokudaki benign ve malign kitlelerin ayırımında tanısal doğruluğunu değerlendirmek. YÖNTEM ve GEREÇLER: Çalışmaya 36 hastada saptanan 36 yumuşak doku kitlesi dahil edilmiştir (17 malign, 19 benign). MR görüntüleri 3T MRG cihazı (Philips MR Systems Achieva Release 2.6.3.7, Eindhoven, Netherlands) ile çalışılmıştır. MRG sırasında her hastaya T2 Perfüzyon ile T2 relaksometri uygulanmış ve yumuşak doku kitlelerinde Index, Negative Integral (NI), Mean Transit Time (MTT), Time to Peak (TTP), Time of Arrival (T0) ve T2 relaksometri zamanı (ortalama değeri) ölçülmüştür. Bu parametreler benign-malign lezyonlar arasında karşılaştırılmıştır. BULGULAR: Benign ve malign kitleler arasında lezyonların maksimum boyutu ile NI değerlerinin farklılıkları istatistiksel olarak anlamlı bulundu (sırasıyla p = 0.01 ve p = 0.001). Peritümöral ödem varlığı ile malignite arasında istatistiksel olarak anlamlı bir ilişki vardı (p = 0.05). TARTIŞMA ve SONUÇ: Benign-malign yumuşak doku kitlelerinin ayrımında T2 perfüzyon NI değeri, konvansiyonel MRG ve klinik bulgularla birlikte değerlendirildiğinde değerli bilgiler sağlayabilir. Benign-malign kitleler arasındaki örtüşme nedeniyle T2 relaksasyon zamanı bu konuda yardımcı olmamıştı

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Kaya T. Yumuşak Doku Kitleleri, Kas İskelet Yumuşak Doku Radyolojisi Bursa: Güneş Tıp Kitabevi. 2008: 537-577.
2. Tuncbilek N, Karakas HM, Okten OO. Dynamic magnetic resonance imaging in determining histopathological prognostic factors of invasive breast cancers. Eur J Radiol 2005; 53: 199-205 https://doi.org/10.1016/j.ejrad.2003.11.004
3. Lenz M. Computed Tomography and Magnetic Resonance Imaging of Head and Neck Tumours; Stuttgart: George Thieme. 1993.
4. Kransdorf MJ and Murphey MD. Radiologic Evaluation of Soft Tissue Masses: ACurrent Perspective. Am J Roentgenol 2000; 175: 575-87. https://doi.org/10.2214/ajr.175.3.1750575
5. Crim JR, Seeger LL, Yao L, Chandani V, Eckardt JJ. Diagnosis of soft-tissue masses with MR imaging: can benign masses be differentiated from malignant ones? Radiology 1992; 185: 581-586. https://doi.org/10.1148/radiology.185.2.1410377
6. Moulton JS, Blebea JS, Dunco DM, Braley SE, Bisset GS 3rd, Emery KH. MR imaging ofsoft tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions. Am J Roentgenol 1995; 164: 1191-1199. https://doi.org/10.2214/ajr.164.5.7717231
7. Tuncbilek N, Karakas HM, Okten OO. Dynamic contrast enhanced MRI in the differential diagnosis of soft tissue tumors. Eur J Radiol 2005; 53: 500-505. https://doi.org/10.1016/j.ejrad.2004.04.012
8.RudischA, Kremser C,Judmaier W, Zunterer H, DeVries AF. Dynamic contrast-enhanced magnetic resonance imaging: a non-invasive method to evaluate significant differences between malignant and normal tissue. Eur J Radiol 2004; 53: 514-519. https://doi.org/10.1016/j.ejrad.2004.06.002
9. Berquist TH, Ehman RL, King BF, Hodgman CG, Ilstrup DM. Value of MR imaging in differentiating benign from malignant soft-tissue masses: study of 95 lesions. Am J Roentgenol 1990; 155: 1251-1255. https://doi.org/10.2214/ajr.155.6.2122675
10. Chung WJ, Chung HW, Shin MJ, Lee SH, Lee MH, Lee JS, et al. MRI to differentiate benign from malignant soft-tissue tumours of the extremities: a simplified systematic imaging approach using depth, size and heterogeneity of signal intensity: Br J Radiol 2012 Oct; 85(1018): e831-e836. https://doi.org/10.1259/bjr/27487871
11. Wing P Chan. Magnetic resonance imaging of soft-tissue tumors of the extremities: A practical approach: World J Radiol 2013 Dec 28; 5(12): 455-459. https://doi.org/10.4329/wjr.v5.i12.455
12. Chen CK, Wu HT, Chiou HJ, Wei CJ, Yen CH, Chang CY, et al. Differentiating benign and malignant soft tissue masses by magnetic resonance imaging: role of tissue component analysis. J Chin Med Assoc 2009; 72(4):194-201. https://doi.org/10.1016/S1726-4901(09)70053-X
13. Calleja M, Dimigen M, Saifuddin A. MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions. Skeletal Radiol 2012; 41(12):1517-24. https://doi.org/10.1007/s00256-012-1385-6
14. Kransdorf MJ, Jelinek JS, Moser RP Jr, Utz JA, Brower AC, Hudson TM, et al. Soft tissue masses: diagnosis using MR imaging. AJR Am J Roentgenol 1989; 153: 541-547 https://doi.org/10.2214/ajr.153.3.541
15. Kransdorf MJ, Jelinek JS, Moser RP Jr. Imaging of soft tissue tumors. Radiol Clin North Am 1993; 31: 359-372.
16. van Rijswijk CS, Geirnaerdt MJ, Hogendoorn PC, Taminiau AH, van Coevorden F, Zwinderman AH, et al. Soft Tissue Tumors: Value of Static and Dynamic Gadopentetate Dimeglumine-enhanced MR Imaging in Prediction of Malignancy. Radiology 2004; 233:493-502. https://doi.org/10.1148/radiol.2332031110
17. Beltran J, Chandnani V, McGhee RA Jr, Kursunoglu-Brahme S. Gadopentetate dimeglumine-enhanced MR imaging of the musculoskeletal system. Am J Roentgenol 1991; 156: 457-466. https://doi.org/10.2214/ajr.156.3.1899738
18. Van derWoude HJ,Verstraete KL, Hogendoorn PC, Taminiau AH, Hermans J, Bloem JL. Musculoskeletal tumors: does fast dynamic contrast-enhanced subtraction MR imaging contribute to the characterization? Radiology 1998; 208: 821-828. https://doi.org/10.1148/radiology.208.3.9722866
19. Mutlu H, Silit E, Pekkafali Z, Basekim CC, Ozturk E, Sildiroglu O, et al. Soft-tissue masses: use of a scoring system in differentiation of benign and malignant lesions. Clin Imaging 2006; 30: 37-42. https://doi.org/10.1016/j.clinimag.2005.06.027
20. Hough TJ, Tung GA, Terek RM. Staging, characterization, and grading. In: Schepper De, Parizel PA, Ramon F, et al., editors. Imaging of soft tissue tumors. Berlin, Heidelberg: Springer; 1997. p. 113-25. https://doi.org/10.1007/978-3-662-07859-4_7
21. Verstraete KL, De Deene Y, Roels H, Dierick A, Uyttendaele D, Kunnen M. Benign and malignant musculoskeleteal lesions: dynamic contrast-enhanced MR imaging-parametric “first pass” images depict tissue vascularization and perfusion. Radiology 1994;192:835- 43. https://doi.org/10.1148/radiology.192.3.8058957
22. Moulton JS, Blebea JS, Dunco DM, Braley SE, Bisset III GS, Emery KH. MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions. AJR 1995;164:1191-9. https://doi.org/10.2214/ajr.164.5.7717231
23. Ma LD, Frassica FJ, McCarthy EF, Bluemke DA, Zerhouni EA. Benign and malignant musculoskeletal masses: MR imaging differentiation with rim-to-center differential enhancement ratios. Radiology 1997;202:739-44. https://doi.org/10.1148/radiology.202.3.9051028
24. Erlemann R, Sciuk J, Wuisman P, Bene D, Edel G, Ritter J, et al. Dynamic MR tomography in the diagnosis of inflammatory and tumorous space-occupying lesions of the musculoskeletal system. RofoFortschrGebRontgenstr 1992;156:353-9. https://doi.org/10.1055/s-2008-1032900
25. Erlemann R, Reiser M, Peters PE, Vasallo P, Nommensen B, Kusnierz-Glaz CR, et al. Musculoskeletealneoplasms:static and dynamic Gd-DTPA enhanced MR imaging. Radiology 1989;171:767- 73. https://doi.org/10.1148/radiology.171.3.2717749
26. Mirowitz S, Totty W, Lee J. Characterization of musculoskeletal masses using dynamic Gd-DTPA enhanced spin-echo MRI. J Comput Assist Tomogr 1992;16:120-5.
27. Tacikowska M. Dynamic magnetic resonance imaging in soft tissue tumors-assessment of the diagnostic value of tumor enhancement rate indices. Med Sci Monit 2002;8:53-7.
28. Tacikowska M. Dynamic MR imaging of soft tissue tumors with assesment of the rate and character of lesion enhancement. Med Sci Monit 2002;8:31-5.
29. Buadu LD, Murakami J, Murayama S, Hashiguchi N, Sakai S, Masuda K, et al. Breast lesions:correlation of contrast medium enhancement patterns on MR images with histopathologic findings and tumor angiogenesis. Radiology evaluation and monitoring chemotherapy in patients with high-grade osteogenic and Ewing’s sarcoma: review of current imaging modalities. Skeletal Radiol 1998; 27:57-71. https://doi.org/10.1007/s002560050339 1996; 2000:639-49. https://doi.org/10.1148/radiology.200.3.8756909
30. Tuncbilek N, Unlu E, Karakas HM, Cakir B, Ozyilmaz F. Evaluation of tumor angiogenesis with contrast-enhanced MR mammography. Breast J 2003; 9:403-8. https://doi.org/10.1046/j.1524-4741.2003.09508.x
31. Tuncbilek N, Karakas HM, Altaner S. Dynamic MRI in indirect estimation of MVD in colorectal adenocarcinomas. Abdom Imaging 2004;29(2):166-72. https://doi.org/10.1007/s00261-003-0090-2
32. Van der Woude HJ, Bloem JL, Hogendoorn PC. Preoperative evaluation and monitoring chemotherapy in patients with high-grade osteogenic and Ewing’s sarcoma: review of current imaging modalities. Skeletal Radiol 1998; 27:57-71. https://doi.org/10.1007/s002560050339
33. Hu LS, Baxter LC, Pinnaduwage DS, Paine TL, Karis JP, Feuerstein BG, et al. Optimized Preload Leakage-Correction Methods to Improve the Diagnostic Accuracy of Dynamic Susceptibility-Weighted Contrast-Enhanced Perfusion MR Imaging in Posttreatment Gliomas. Am J Neuroradiol 2010 31: 40-48. https://doi.org/10.3174/ajnr.A1787
34. C.As Lavini, M.S. Buiter, M. Maas. Use of dynamic contrast enhanced time intensity curve shape analysis in MRI: theory and practice. Rep Med Imaging 6 (2013), pp. 71-82. https://doi.org/10.2147/RMI.S35088

APA	USLU H, tosun m, Akansel G, ANIK Y, ÇİFTÇİ E (2021). Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. , 111 - 118. 10.5505/KTD.2021.46667
Chicago	USLU Hande,tosun mesude,Akansel Gür,ANIK YONCA,ÇİFTÇİ ERCÜMENT Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. (2021): 111 - 118. 10.5505/KTD.2021.46667
MLA	USLU Hande,tosun mesude,Akansel Gür,ANIK YONCA,ÇİFTÇİ ERCÜMENT Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. , 2021, ss.111 - 118. 10.5505/KTD.2021.46667
AMA	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. . 2021; 111 - 118. 10.5505/KTD.2021.46667
Vancouver	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. . 2021; 111 - 118. 10.5505/KTD.2021.46667
IEEE	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E "Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses." , ss.111 - 118, 2021. 10.5505/KTD.2021.46667
ISNAD	USLU, Hande vd. "Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses". (2021), 111-118. https://doi.org/10.5505/KTD.2021.46667

APA	USLU H, tosun m, Akansel G, ANIK Y, ÇİFTÇİ E (2021). Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. Kocaeli Tıp Dergisi, 10(2), 111 - 118. 10.5505/KTD.2021.46667
Chicago	USLU Hande,tosun mesude,Akansel Gür,ANIK YONCA,ÇİFTÇİ ERCÜMENT Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. Kocaeli Tıp Dergisi 10, no.2 (2021): 111 - 118. 10.5505/KTD.2021.46667
MLA	USLU Hande,tosun mesude,Akansel Gür,ANIK YONCA,ÇİFTÇİ ERCÜMENT Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. Kocaeli Tıp Dergisi, vol.10, no.2, 2021, ss.111 - 118. 10.5505/KTD.2021.46667
AMA	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. Kocaeli Tıp Dergisi. 2021; 10(2): 111 - 118. 10.5505/KTD.2021.46667
Vancouver	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses. Kocaeli Tıp Dergisi. 2021; 10(2): 111 - 118. 10.5505/KTD.2021.46667
IEEE	USLU H,tosun m,Akansel G,ANIK Y,ÇİFTÇİ E "Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses." Kocaeli Tıp Dergisi, 10, ss.111 - 118, 2021. 10.5505/KTD.2021.46667
ISNAD	USLU, Hande vd. "Diagnostic Performances of Dynamic Contrast Enhanced Magnetic Resonance Perfusion Imaging and T2 Relaxometry in Soft Tissue Masses". Kocaeli Tıp Dergisi 10/2 (2021), 111-118. https://doi.org/10.5505/KTD.2021.46667