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Myxofibrosarcoma: prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging.
MedLine Citation:
PMID:  23318907     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Myxofibrosarcoma frequently shows curvilinear extensions of high T2 signal that also enhance on magnetic resonance imaging; these "tails" represent fascial extension of tumor at histopathological examination. This study was performed to determine whether the tail sign is helpful in distinguishing myxofibrosarcoma from other myxoid-containing neoplasms. MATERIALS AND METHODS: The study group consisted of 44 patients with pathologically proven myxofibrosarcoma; the control group consisted of 52 patients with a variety of other myxoid-predominant tumors. Three musculoskeletal radiologists independently evaluated T2-weighted (and/or short-tau inversion recovery) and post-contrast MR images for the presence of one or more enhancing, high-signal intensity, curvilinear projections from the primary mass. Sensitivity and specificity for the diagnosis of myxofibrosarcoma were calculated for each reader. Interobserver variability was assessed with kappa statistic and percentage agreement. RESULTS: A tail sign was deemed present in 28, 30, and 34 cases of myxofibrosarcoma and in 11, 9, and 5 of the controls for the three readers respectively, yielding a sensitivity of 64-77 % and a specificity of 79-90 %. The interobserver agreement was moderate-to-substantial (kappa = 0.626). CONCLUSION: The tail sign at MRI is a moderately specific and sensitive sign for the diagnosis of myxofibrosarcoma relative to other myxoid-containing tumors.
Authors:
Robert A Lefkowitz; Jonathan Landa; Sinchun Hwang; Emily C Zabor; Chaya S Moskowitz; Narasimhan P Agaram; David M Panicek
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-15
Journal Detail:
Title:  Skeletal radiology     Volume:  -     ISSN:  1432-2161     ISO Abbreviation:  Skeletal Radiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701953     Medline TA:  Skeletal Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA, lefkowir@mskcc.org.
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