Qualitative and Quantitative MRI Analysis of Alveolar Soft Part Sarcoma: Correlation with Histological Grade and Ki-67 Expression

Overview

Journal Insights Imaging

Publisher Springer

Specialty Radiology

Date 2024 Jun 12

PMID 38866951

Authors

Junhui Yuan

Deshun Xie

Shaobo Fang

Fan Meng

Yue Wu

Dongqiu Shan

Nannan Shao

Bangmin Wang

Zhichao Tian

Yuanyuan Wang

Chunmiao Xu

Xuejun Chen

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the correlation between MRI findings and histological features for preoperative prediction of histological grading and Ki-67 expression level in alveolar soft part sarcoma (ASPS).

Methods: A retrospective analysis was conducted on 63 ASPS patients (Jan 2017-May 2023). All patients underwent 3.0-T MRI examinations, including conventional sequences, dynamic contrast-enhanced scans with time-intensity curve analysis, and diffusion-weighted imaging with apparent diffusion coefficient (ADC) measurements. Patients were divided into low-grade (histological Grade I) and high-grade (histological Grade II/III) groups based on pathology. Immunohistochemistry was used to assess Ki-67 expression levels in ASPS. Statistical analysis included chi-square tests, Wilcoxon rank-sum test, binary logistic regression analysis, Spearman correlation analysis, and receiver operating characteristic curve analysis of various observational data.

Results: There were 29 low-grade and 34 high-grade patients (26 males and 37 females) and a wide age range (5-68 years). Distant metastasis, tumor enhancement characteristics, and ADC values were independent predictors of high-grade ASPS. High-grade ASPS had lower ADC values (p = 0.002), with an area under the curve (AUC), sensitivity, and specificity of 0.723, 79.4%, and 58.6%, respectively, for high-grade prediction. There was a negative correlation between ADC values and Ki-67 expression (r = -0.526; p < 0.001). When the cut-off value of ADC was 0.997 × 10 mm²/s, the AUC, sensitivity, and specificity for predicting high Ki-67 expression were 0.805, 65.6%, and 83.9%, respectively.

Conclusion: Qualitative and quantitative MRI parameters are valuable for predicting histological grading and Ki-67 expression levels in ASPS.

Critical Relevance Statement: This study will help provide a more nuanced understanding of ASPS and guide personalized treatment strategies.

Key Points: There is limited research on assessing ASPS prognosis through MRI. Metastasis, enhancement, and ADC correlated with histological grade; ADC related to Ki-67 expression. MRI provides clinicians with valuable information on ASPS grading and proliferation activity.

References

Li X, Wu S, Li D, Yu T, Zhu H, Song Y . Intravoxel Incoherent Motion Combined With Dynamic Contrast-Enhanced Perfusion MRI of Early Cervical Carcinoma: Correlations Between Multimodal Parameters and HIF-1α Expression. J Magn Reson Imaging. 2019; 50(3):918-929. DOI: 10.1002/jmri.26604. View

Ogose A, Yazawa Y, Ueda T, Hotta T, Kawashima H, Hatano H . Alveolar soft part sarcoma in Japan: multi-institutional study of 57 patients from the Japanese Musculoskeletal Oncology Group. Oncology. 2003; 65(1):7-13. DOI: 10.1159/000071199. View

Yuan Y, Zeng D, Liu Y, Tao J, Zhang Y, Yang J . DWI and IVIM are predictors of Ki67 proliferation index: direct comparison of MRI images and pathological slices in a murine model of rhabdomyosarcoma. Eur Radiol. 2019; 30(3):1334-1341. DOI: 10.1007/s00330-019-06509-w. View

Li W, Zhang S, Fan W, Li D, Tian H, Che D . Sonographic imaging features of alveolar soft part sarcoma: Case series and literature review. Medicine (Baltimore). 2022; 101(46):e31905. PMC: 9678532. DOI: 10.1097/MD.0000000000031905. View

Portera Jr C, Ho V, Patel S, Hunt K, Feig B, Respondek P . Alveolar soft part sarcoma: clinical course and patterns of metastasis in 70 patients treated at a single institution. Cancer. 2001; 91(3):585-91. DOI: 10.1002/1097-0142(20010201)91:3<585::aid-cncr1038>3.0.co;2-0. View

Sbaraglia M, Bellan E, Dei Tos A . The 2020 WHO Classification of Soft Tissue Tumours: news and perspectives. Pathologica. 2020; 113(2):70-84. PMC: 8167394. DOI: 10.32074/1591-951X-213. View

Carbonnaux M, Brahmi M, Schiffler C, Meeus P, Sunyach M, Bouhamama A . Very long-term survivors among patients with metastatic soft tissue sarcoma. Cancer Med. 2019; 8(4):1368-1378. PMC: 6488206. DOI: 10.1002/cam4.1931. View

Barrientos-Ruiz I, Ortiz-Cruz E, Serrano-Montilla J, Bernabeu-Taboada D, Pozo-Kreilinger J . Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?. Clin Orthop Relat Res. 2016; 475(2):511-518. PMC: 5213942. DOI: 10.1007/s11999-016-5090-y. View

Lee J, Yoon Y, Seo S, Choi Y, Kim H . Soft tissue sarcoma: DWI and DCE-MRI parameters correlate with Ki-67 labeling index. Eur Radiol. 2019; 30(2):914-924. DOI: 10.1007/s00330-019-06445-9. View

10.

Wang H, Jacobson A, Harmon D, Choy E, Hornicek F, Raskin K . Prognostic factors in alveolar soft part sarcoma: A SEER analysis. J Surg Oncol. 2016; 113(5):581-6. DOI: 10.1002/jso.24183. View

11.

Hoos A, Stojadinovic A, Mastorides S, URIST M, Polsky D, Di Como C . High Ki-67 proliferative index predicts disease specific survival in patients with high-risk soft tissue sarcomas. Cancer. 2001; 92(4):869-74. DOI: 10.1002/1097-0142(20010815)92:4<869::aid-cncr1395>3.0.co;2-u. View

12.

Cui J, Chen H, Hao D, Liu J, Hou F, Xu W . Magnetic Resonance Features and Characteristic Vascular Pattern of Alveolar Soft-Part Sarcoma. Oncol Res Treat. 2017; 40(10):580-585. DOI: 10.1159/000477443. View

13.

Chang H, Wang D, Li Y, Xiang S, Yang Y, Kong P . Evaluation of breast cancer malignancy, prognostic factors and molecular subtypes using a continuous-time random-walk MR diffusion model. Eur J Radiol. 2023; 166:111003. DOI: 10.1016/j.ejrad.2023.111003. View

14.

Fang S, Yang Y, Tao J, Yin Z, Liu Y, Duan Z . Intratumoral Heterogeneity of Fibrosarcoma Xenograft Models: Whole-Tumor Histogram Analysis of DWI and IVIM. Acad Radiol. 2022; 30(10):2299-2308. DOI: 10.1016/j.acra.2022.11.016. View

15.

Huang Z, Xu X, Meng X, Hou Z, Liu F, Hua Q . Correlations between ADC values and molecular markers of Ki-67 and HIF-1α in hepatocellular carcinoma. Eur J Radiol. 2015; 84(12):2464-9. DOI: 10.1016/j.ejrad.2015.09.013. View

16.

Li X, Tao J, Zhu Y, Yin Z, Zhang Y, Wang S . Soft tissue sarcoma: intravoxel incoherent motion and diffusion kurtosis imaging parameters correlate with the histological grade and Ki-67 expression. Acta Radiol. 2022; 64(4):1546-1555. DOI: 10.1177/02841851221131931. View

17.

Sood S, Baheti A, Shinagare A, Jagannathan J, Hornick J, Ramaiya N . Imaging features of primary and metastatic alveolar soft part sarcoma: single institute experience in 25 patients. Br J Radiol. 2014; 87(1036):20130719. PMC: 4097810. DOI: 10.1259/bjr.20130719. View

18.

Paoluzzi L, Maki R . Diagnosis, Prognosis, and Treatment of Alveolar Soft-Part Sarcoma: A Review. JAMA Oncol. 2018; 5(2):254-260. DOI: 10.1001/jamaoncol.2018.4490. View

19.

Fang S, Yang Y, Xu N, Tu Y, Yin Z, Zhang Y . An Update in Imaging Evaluation of Histopathological Grade of Soft Tissue Sarcomas Using Structural and Quantitative Imaging and Radiomics. J Magn Reson Imaging. 2021; 55(5):1357-1375. DOI: 10.1002/jmri.27954. View

20.

Crombe A, Brisse H, Ledoux P, Haddag-Miliani L, Bouhamama A, Taieb S . Alveolar soft-part sarcoma: can MRI help discriminating from other soft-tissue tumors? A study of the French sarcoma group. Eur Radiol. 2018; 29(6):3170-3182. DOI: 10.1007/s00330-018-5903-3. View