ArticlePediatric radiology2019
Usefulness of diffusion-weighted MRI in the initial assessment of osseous sarcomas in children and adolescents.
Article in Pediatric radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Imaging of ewing sarcoma: an updated analysis including presenting features, prognostic imaging biomarkers, and treatment response assessment.Skeletal radiology · 2026Review
- Multiparametric MRI biomarkers in pediatric osteosarcoma: associations of ADC, necrosis, and tumor volume with histologic and clinical outcomes in a retrospective cohort study.Pediatric radiology · 2026Article
- Ewing sarcoma of the temporal bone with aneurysmal bone cyst-like changes: A rare case report with an unusual radiological presentation.The neuroradiology journal · 2024Article
- Pitfalls of Diffusion-Weighted Imaging: Clinical Utility of T2 Shine-through and T2 Black-out for Musculoskeletal Diseases.Diagnostics (Basel, Switzerland) · 2023Review
- Methodological considerations on segmenting rhabdomyosarcoma with diffusion-weighted imaging-What can we do better?Insights into imaging · 2023Review
- Multiparametric MRI evaluation of bone sarcomas in children.Insights into imaging · 2022Review
- Strategies to perform magnetic resonance imaging in infants and young children without sedation.Pediatric radiology · 2022Review
- Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications.Pediatric radiology · 2021Review
- Article
- Revisiting the WHO classification system of bone tumours: emphasis on advanced magnetic resonance imaging sequences. Part 2.Polish journal of radiology · 2020Review
- Radiomics signature extracted from diffusion-weighted magnetic resonance imaging predicts outcomes in osteosarcoma.Journal of bone oncology · 2019Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcern regarding gadolinium deposition in the brain after repeated administration of intravenous gadolinium-based contrast agents has prompted evaluation of imaging alternatives.
objectiveThe study purpose was to determine if magnetic resonance imaging (MRI) using conventional sequences with diffusion-weighted imaging (DWI) instead of gadolinium-based contrast-enhanced MRI is valid for local staging and guiding biopsies in osseous sarcomas. MATERIALS AND
methodsInitial pretreatment MRI with DWI and gadolinium-based contrast-enhanced images in patients ≤ 18 years with histopathologically proven osseous sarcomas were included. Two radiologists blinded to collated demographic and clinical data, independently reviewed conventional/DWI and conventional/gadolinium-based contrast-enhanced MRI then conventional sequences alone, recording tumor size, skip lesions, necrosis, neurovascular invasion, enlarged lymph nodes and diffusion restriction. Discrepancies were resolved by a third reader. A single reader measured apparent diffusion coefficient (ADC) values in non-necrotic tumors, then correlated minimum ADC values -- with and without normalization to skeletal muscle -- with relative enhancement.
resultsTwenty-one patients (mean age: 11.3±4.2 years, 15 [71%] females) had 14 osteosarcomas and 7 Ewing sarcomas, 50% centered in the femur. Conventional/DWI versus conventional/gadolinium-based contrast-enhanced MRI showed agreement for tumor size estimation with significant associations for necrosis (P=0.021), neurovascular involvement (P<0.001) and enlarged lymph nodes (P=0.005). Diagnostic accuracy of conventional/DWI is comparable to conventional/gadolinium-based contrast-enhanced MRI and superior to conventional sequences alone. Comparison between minimum ADC values and relative enhancement showed no correlation (P>0.05).
conclusionSignificant associations of key imaging features in the initial assessment of osseous sarcomas support DWI as an alternative to gadolinium-based contrast-enhanced MRI. The lack of association between ADC values and relative enhancement suggests that they measure independent constructs, DWI dependent upon tumor cellularity and perfusion.
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