Characteristics of Apparent Diffusion Coefficient and Time Intensity Curve in AdvancedMagnetic Resonance Imaging of Malignant Soft Tissue Tumors

Abstract

Malignant soft tissue tumors are usually identified and characterized by conventional magnetic resonance
imaging (MRI) due to its high resolution on soft tissues. However,combinationof advanced MRI and
conventional MRI increases the accuracy. This study was conducted to assess the characteristics of apparent
diffusion coefficient(ADC) and time intensity curve (TIC) in dynamic contrast-enhanced MRI (DCE-MRI)
in malignant soft tissue tumors. A cross-sectional study was conducted inDr. Soetomo Hospital, Surabaya,
Indonesia. Demographic and clinical data, theclassification of malignant soft tissue tumor, histopathological
examination results, ADC value, and TIC of DCE-MRI were collected.Between 1st January2018 and 30th
August 2020, 30 malignant soft tissue tumors were included of which the most common malignantsoft tissue
tumorsoccurred in those who were older than 50 year (30.0%) and located in the femur (33.3%). The most
common tumor was synovial sarcoma (23.3%) and undifferentiated pleiomorphic sarcoma (20.0%). Type
4 and 3 of TIC were found in 92.0% and 8.0%, respectively. The overall mean of ADC and steepest slope
were 0.84x10-3±0.14x10-3mm2
/sand 15.8%±19.9%, respectively. The highest and the lowest mean ADCwas
observed in squamous cell carcinoma and squamous cell carcinoma, and malignant peripheral nerve sheath
tumor (MPNST), respectively. In contrast, the highest and the lowest steepest slopewas found in MPNST and
squamous cell carcinomawith 75.43% and 2.45%, respectively.In conclusion, information of TICparameters
such as ADCvalue and steepest slope might potentially be used in determining the histopathologic types of
malignant soft tissue tumors.