Configuration of soft-tissue sarcoma on MRI correlates with grade of malignancy

Abstract

Objective: To assess whether the configuration of primary soft-tissue sarcoma (STS) on MRI correlates with the grade of malignancy.

Methods: 71 patients with histologically proven STS were included. Primary STS were examined for configuration, limitation, and volume on MRI. The tumors were divided into high-grade (G3), intermediate-grade (G2) and low-grade (G1) STS according to the grading system of the French Federation of Cancer Centers Sarcoma Group (FNCLCC).

Results: 30 high-grade, 22 intermediate-grade and 19 low-grade primary STS lesions were identified. High- and intermediate-grade (G3/2) STS significantly most often appeared as polycyclic/multilobulated tumors (p<0.001 and p=0.002, respectively). Low-grade (G1) STS mainly showed an ovoid/nodular or streaky configuration (p=0.008), and well-defined borders (95%). The appearance of high-, intermediate- and low-grade STS with an ovoid/nodular configuration were mainly the same on MRI. All streaky G3/2 sarcoma and 17 of 20 patients with polycyclic/multilobulated G3 sarcoma showed infiltrative borders. High-grade streaky and polycyclic/multilobulated STS are larger in volume, compared to intermediate- and low-grade STS.

Conclusion: Configuration of STS on MRI can indicate the grade of malignancy. Higher-grade (G2/3) STS most often show a polycyclic/multilobulated configuration, while low-grade STS are mainly ovoid/nodular or streaky. Infiltrative behavior might suggest higher-grade STS in streaky and polycyclic/multilobulated STS.