- •T2, T2* relaxometry can be used to support diagnosis for lipomatous neoplasms.
- •The amount of signal loss related to spin coupling phenomena is indicative of lipomatous tumor histological grading.
- •Pre-operative biopsy guidance can be facilitated as areas of good or poor differentiation are identified on a pixel basis.
Subcutaneous fat may have variable signal intensity on T2w images depending on the choice of imaging parameters. However, fatty components within tumors have a different degree of signal dependence on the acquisition scheme. This study examined the use of T2, T2* relaxometry and spin coupling related signal changes (Spin Coupling ratio, SCr) on two different imaging protocols as clinically relevant descriptors of benign and malignant lipomatous tumors.
Materials and methods
20 patients with benign lipomas or liposarcomas of variable histologic grade were examined at an 1.5 T scanner with Multi Echo Spin Echo (MESE) different echo spacing (ESP) in order to produce bright fat T2w images (ESP: 13.4 ms, 25 equidistant echoes) and dark fat images (ESP: 26.8 ms with 10 equidistant echoes). T2* relaxometry acquisition comprises 4 sets of in-opposed echoes (2.4–19.2 ms, ESP: 2.4 ms) Multi Echo Gradient Echo (MEGRE) sequence. All parametric maps were calculated on a pixel basis.
Significant differences of SCr were found for five different types of lipomatous tumors (Pairwise t-test with Bonferroni correction): lipomas, well differentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and poorly differentiated liposarcomas. SCr surpassed the classification performance of T2 and T2* relaxometry.
A novel biomarker based on spin coupling related signal loss, SCr, is indicative of lipomatous tumor histological grading. We concluded that T2, T2* and SCr can be used for the classification of fat containing tumors, which may be important for biopsy guidance in heterogeneous masses and treatment planning.
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Published online: March 28, 2019
Accepted: March 21, 2019
Received in revised form: March 19, 2019
Received: February 15, 2019
© 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.