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  • 1
    Electronic Resource
    Electronic Resource
    Monitoring the effect of chemotherapy in Ewing's sarcoma of bone with MR imaging (1994)
    Springer
    Skeletal radiology 23 (1994), S. 493-500 
    Details
    ISSN: 1432-2161
    Keywords: Bone tumour ; Bone neoplasm ; Ewing's sarcoma ; MR imaging ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetic resonance (MR) imaging was performed in 26 patients with Ewing's sarcoma of bone preceding and following neoadjuvant chemotherapy, to assess tumour response non-invasively prior to surgery. T1- and T2-weighted spin echo images were obtained. Changes including intra- and extramedullary signal intensities, tumour demarcation, tumour volume and the appearance of residual extramedullary tumour were compared with histopathology of the resected specimens. Reduction of tumour volume was significantly higher in good responders. Other single parameters did not correlate with histologic tumour response. However, when several MR parameters summarized in a classification system were combined, a positive correlation with histopathologic response was found. A limited decrease of tumour volume (〈25%) and/or residual soft tissue mass following chemotherapy correlated with a poor response. An inhomogeneous, well-defined cuff of abnormal tissue encircling the bone and/or radiological disappearance of the soft tissue tumour component following chemotherapy correlated with good response. Twenty-three out of 26 patients were correctly classified by MR as good or poor responders. Minimal residual disease (〈10% of the entire tumour volume), observed histologically, could not be identified with MR imaging. Tumour volume reduction and residual extramedullary tumour, rather than changes of signal intensity, are major features for evaluating the response to chemotherapy in Ewing's sarcoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00223076
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  • 2
    Electronic Resource
    Electronic Resource
    MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review (2000)
    Springer
    Skeletal radiology 29 (2000), S. 187-195 
    Details
    ISSN: 1432-2161
    Keywords: Key words Clear cell sarcoma ; Malignant melanoma of soft parts ; MRI ; Magnetic resonance ; Neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts). Design and patients. MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study. Results. On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody. Conclusions. Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050592
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Maligne Knorpeltumoren (1998)
    Springer
    Der Radiologe 38 (1998), S. 502-508 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Chondrosarkom ; Radiologische Diagnose ; Magnetresonanztomographie (MRI) ; Kontrastmittel ; Key words Cartilage ; Sarcoma ; Diagnostic radiology ; Magnetic resonance (MR) ; contrast agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Malignant cartilaginous tumors (chondrosarcomas) are, with a relative frequency of 20%, the second most common malignant tumors of bone after osteosarcoma. The diagnosis of chondrosarcoma can usually be made confidently based on combination of clinical information, radiographs, Gd-enhanced MR imaging, and histologic examination of a biopsy sample. The combination of these parameters is important because accuracy of histologic diagnosis is adversely affected by unrepresentative sampling of these usually large tumors. The prognosis of patients with chondrosarcoma becomes poorer with more axial location, higher histologic grade, larger tumor size and inadeqaute resection. By careful analysis of radiographs and Gd-enhanced MR imaging the radiologist has the ability to improve the management of patients with chondrosarcoma.
    Notes: Zusammenfassung Die malignen Knorpeltumoren oder Chondrosarkome treten in einer Inzidenz von 20% auf und sind damit die zweithäufigsten primären malignen Tumoren des Knochens nach dem Osteosarkom. Üblicherweise kann in Zusammenschau von klinischer Information, Nativröntgenbildern und Kontrastmittel-MR-Untersuchung sowie Histologie eine zuverlässige Diagnose gestellt werden. Es ist wichtig, alle diese Modalitäten in ihrer Gesamtheit zu betrachten, da die Histologien manchmal durch nichtrepräsentative Gewebsentnahmen aus diesen oft großen Tumoren ungenau sind. Die Prognose von Chondrosarkomen verschlechtert sich bei stammnaher Lokalisation, hohem Grading, zunehmender Tumorgröße und insuffizienter Resektion. Durch sorgfältige Interpretation von Röntgenaufnahmen und MR-Kontrastmitteluntersuchungen liegt es in der Hand des Radiologen die Behandlung von Chondrosarkompatienten zu optimieren.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050385
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Classification of histopathologic changes following chemotherapy in Ewing's sarcoma of bone (1994)
    Springer
    Skeletal radiology 23 (1994), S. 501-507 
    Details
    ISSN: 1432-2161
    Keywords: Bone tumour ; Bone neoplasm ; Ewing's sarcoma ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A uniform classification of response to chemotherapy is essential to allow comparison of local effect and ultimate prognosis between different therapy schedules. We define a histological grading system for assessment of the response to chemotherapy in Ewing's sarcoma, based on the amount and architectural pattern of residual histologically viable-appearing tumour, the preferential sites of minimal residual tumour and the amount of tumour necrosis. Twenty-six consecutive patients with a biopsy-proven Ewing's sarcoma were treated with chemotherapy prior to surgery. The effect of chemotherapy was evaluated microscopically on the specimens obtained after surgery. Response to chemotherapy was classified as minimal or no effect (〈10% tumour necrosis), moderate effect (solid areas of remnant viable tumour), minimal residual disease, and no evidence of disease (100% tumour necrosis or well-vascularized fibrous tissue). The subperiosteal area in particular, and, less frequently, soft tissues and intramedullary compartment were identified as sites of predilection for persistence of microscopic viable tumour foci, frequently depicted as pseudo-rosettes in a characteristic scattered pattern. Although it is not well known whether morphological viability of these residual clusters in Ewing's sarcoma indicates biological viability, accurate preoperative local staging, with special attention to preferential sites of residual viable tumour, is essential. The proposed grading system can be used to standardize assessment of chemotherapy in trials, and may serve as a standard for non-invasive monitoring of preoperative chemotherapy with magnetic resonance imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00223077
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    Paper (German National Licenses)
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