ReviewCureus2024
Magnetic Resonance Imaging Features for Distinguishing High-Grade From Low-Grade Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis.
Review in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- MRI of soft tissue tumours: a structured "8S framework" aligned with WHO 2020 classification.Skeletal radiology · 2026Review
- MRI analysis of undifferentiated pleomorphic sarcoma: correlating imaging features with histological grade.Quantitative imaging in medicine and surgery · 2026Article
- Feasibility and Tolerability of Arterial Infusion Chemotherapy and Embolization for Recurrent/Metastatic Soft Tissue Sarcoma: A Retrospective Exploratory Study.Drug design, development and therapy · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Soft tissue sarcomas are malignant tumors characterized by heterogeneity and are associated with a high mortality rate. Histopathological grading is considered a pivotal factor in prognostication and treatment planning. While core needle biopsy exhibits high accuracy in determining tumor histology, it fails in some cases, potentially misclassifying high-grade tumors as low-grade. Magnetic resonance imaging (MRI) has been evaluated as an adjunctive tool for predicting histopathological tumor grade. This systematic review and meta-analysis evaluated MRI features capable of distinguishing high-grade from low-grade tumors in patients with soft tissue sarcoma. A literature search was carried out in PubMed, Embase, and Cochrane Central in May 2024. The following features were evaluated for both low-grade and high-grade tumors: tumor size, heterogeneity on T2, presence of necrotic areas, margin definition on T1, and post-contrast peritumoral enhancement. Statistical analysis was conducted using the OpenMeta[Analyst] software (Providence, RI: Brown University), applying random effects models for pooled analyses with a 95% confidence interval (CI) based on the inverse variance method. A total of four studies, involving 343 patients categorized by tumor grade (high-grade or low-grade), who underwent MRI, were included in the analysis. The meta-analysis found similar incidences of tumor sizes less than 5 cm in both high-grade and low-grade tumors (22.7%; 95% CI: 10.3-25% vs. 27%; 95% CI: 2.7-51.2%) and tumor sizes greater than 5 cm (71.3%; 95% CI: 64-78.6% vs. 52%; 95% CI: 23.6-80.5%). High-grade tumors showed a higher incidence of post-contrast peritumoral enhancement compared to low-grade tumors (66%; 95% CI: 43-89% vs. 26%; 95% CI: 4.6-47.4%) as well as heterogeneity on T2 greater than 50% (72.4%; 95% CI: 49.3-95.4% vs. 25.4%; 95% CI: 5.2-56%). Additionally, high-grade tumors had a lower incidence of the absence of necrotic signal compared to low-grade tumors (28.8%; 95% CI: 8.5-49.1% vs. 68%; 95% CI: 57.5-78.6%). Our findings suggest that post-contrast peritumoral enhancement, presence of necrotic areas, and heterogeneity on T2 greater than 50% are MRI features associated with high-grade tumors in soft tissue sarcoma. Tumor size, however, does not appear to be a reliable indicator for differentiating tumor grade.
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