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Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?

Publication ,  Journal Article
Diana Afonso, P; Kosinski, AS; Spritzer, CE
Published in: Eur J Radiol
May 2013

PURPOSE: Evaluate if gadolinium enhanced MR imaging (GeMRI) improves confidence, changes the final diagnosis, or improves accuracy in the assessment of musculoskeletal (MSK) tumor residual or recurrence following surgical resection. We also assess if different experience levels change the above results. METHODS AND MATERIALS: Initially, pre-contrast images were independently reviewed by two radiologists, one with 25 years of experience (R1) and one undergoing MSK specialty training (R2). Two questions were answered: (1) Mass present? and (2) Likelihood of malignancy? Subsequently, both pre-contrast and post-contrast images were independently reviewed. The same questions were again answered plus four others including if GeMRI changed mass characterization, better defined cystic versus solid, better defined tumor extent, or improved conspicuity. Lastly, the readers answered whether GeMRI changed confidence, and changed their final diagnosis. Histologic diagnoses were available in 43 cases, with the remaining 44 cases based upon clinical and/or imaging follow-up. RESULTS: GeMRI definitely improved confidence in 8/7 cases, and slightly improved confidence in 20/29 cases and changed the final diagnosis in 11/8 cases for R1 and R2 respectively. Positive and negative predictive values statistically improved for R2 (positive predictive value 36.4% versus 50%, p=0.02; negative predictive value 75.4% versus 79.1%, p=0.04) but not for R1. Reader concordance for malignancy improved with GeMRI (κ=0.44 pre-contrast and κ=0.71 post-contrast). CONCLUSION: GeMRI improved reader confidence, improved reader concordance and modestly improved accuracy for the less experienced reader. Where possible, GeMRI should be used in the assessment of MSK tumor residual or recurrence.

Duke Scholars

Published In

Eur J Radiol

DOI

EISSN

1872-7727

Publication Date

May 2013

Volume

82

Issue

5

Start / End Page

806 / 813

Location

Ireland

Related Subject Headings

  • Young Adult
  • Soft Tissue Neoplasms
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Professional Competence
  • Prevalence
  • Nuclear Medicine & Medical Imaging
  • North Carolina
  • Neoplasm Recurrence, Local
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Diana Afonso, P., Kosinski, A. S., & Spritzer, C. E. (2013). Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis? Eur J Radiol, 82(5), 806–813. https://doi.org/10.1016/j.ejrad.2012.11.025
Diana Afonso, P., A. S. Kosinski, and C. E. Spritzer. “Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?Eur J Radiol 82, no. 5 (May 2013): 806–13. https://doi.org/10.1016/j.ejrad.2012.11.025.
Journal cover image

Published In

Eur J Radiol

DOI

EISSN

1872-7727

Publication Date

May 2013

Volume

82

Issue

5

Start / End Page

806 / 813

Location

Ireland

Related Subject Headings

  • Young Adult
  • Soft Tissue Neoplasms
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Professional Competence
  • Prevalence
  • Nuclear Medicine & Medical Imaging
  • North Carolina
  • Neoplasm Recurrence, Local
  • Male