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Lookup NU author(s): Dr Corey ChanORCiD, Dr Marcus Brookes, Dr Tamir Ali, Dr Petra Dildey, Dr Michael FirbankORCiD, Dr Rachel Pearson, Professor Philip Sloan, Dr Simon Lowes, Dr Rohit Sinha, Mani Ragbir, Tom Beckingsale, Dr Geoff Hide, Craig Gerrand, Dr Kenneth RankinORCiD, Dr George Petrides
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background/Objectives: Myxofibrosarcomas (MFSs) are aggressive soft-tissue sarcomas (STSs) that often arise in the upper and lower limbs. MFSs are a highly infiltrative sarcoma subtype with a high positive margin rate and poor clinical outcomes. Their management involves multidisciplinary team (MDT) input, with the mainstay of treatment being a wide surgical resection to remove the whole tumour, but this can be challenging due to the infiltrative nature of MFSs through fascial planes. Appropriate pre-operative imaging is therefore essential for surgical planning. Currently, MRI imaging is the modality of choice to assess the soft-tissue extent of MFSs; however, it does not always reliably predict tumour extent, especially when an MRI shows high-signal curvilinear projections, known as “tails”, which often represent tumour extension and increase the risk of positive margins and local recurrence. Methods: This feasibility study therefore aimed to investigate whether the addition of an FDG PET-MRI and DWI MRI is superior for the local staging of MFSs compared to a standard MRI, and to assess its practicality for clinical use. Results: Of the eight patients recruited, six completed the required scans, proceeded to surgery, and were included in the data analyses. Five of the six patients had close (<2 mm) or positive margins requiring re-excision. Conclusions: Our results show that combining an FDG-PET and DWI MRI may offer a more accurate local staging of MFSs than a conventional MRI; however, a larger prospective trial is needed to further investigate this pilot data. Nevertheless, this novel feasibly study demonstrates the potential use of PET-MRI and DWI for improving pre-operative planning prior to the surgical resection of MFSs.
Author(s): Chan CD, Brookes MJ, Ali T, Howell E, Dildey P, Firbank M, Pearson R, Sloan P, Lowes S, Sinha R, Tuckett J, Ragbir M, Beckingsale T, Hide G, Gerrand C, Rankin KS, Petrides GS
Publication type: Article
Publication status: Published
Journal: Diagnostics
Year: 2025
Volume: 15
Issue: 8
Online publication date: 19/04/2025
Acceptance date: 16/04/2025
Date deposited: 01/05/2025
ISSN (electronic): 2075-4418
Publisher: MDPI
URL: https://doi.org/10.3390/diagnostics15081039
DOI: 10.3390/diagnostics15081039
Data Access Statement: The data are available upon reasonable request from the authors.
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