PMID- 30943944 OWN - NLM STAT- MEDLINE DCOM- 20190729 LR - 20200225 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 19 IP - 1 DP - 2019 Apr 3 TI - Differentiating atypical lipomatous tumors from lipomas with magnetic resonance imaging: a comparison with MDM2 gene amplification status. PG - 309 LID - 10.1186/s12885-019-5524-5 [doi] LID - 309 AB - BACKGROUND: To evaluate the diagnostic value of MR imaging for the differentiation of lipomas and atypical lipomatous tumors (ALT) in comparison with histology and MDM2 amplification status. METHODS: Patients with well-differentiated lipomatous tumors (n = 113), of which 66 were diagnosed as lipoma (mean age 53 years (range, 13-82); 47% women) and 47 as atypical lipomatous tumor (ALT; mean age 60 years (range, 28-88); 64% women), were included into this study using histology and MDM2 amplification status by fluorescence in situ hybridization (FISH) as standard of reference. Preoperative MR images were retrospectively assessed by two radiologists for the following imaging features: maximum tumor diameter (mm) as well as the affected compartment (intramuscular, intermuscular or subcutaneous), septa (absent, thin (< 2 mm) or thick septa (> 2 mm) with nodular components); contrast enhancing areas within the lipomatous tumor (< 1/3 of the tumor volume, > 1/3 of the tumor volume); RESULTS: Of the 47 patients with ALT, 40 (85.1%) presented thick septa (> 2 mm) and this finding significantly increased the likelihood of ALT (OR 6.24, 95% CI 3.36-11.59; P < 0.001). The likelihood of ALT was increased if the tumor exceeded a maximum diameter of 130.0 mm (OR 2.74, 95% CI 1.82-4.11, P < 0.001). The presence of contrast enhancement in lipomatous tumors significantly increased the likelihood of ALT (Odds ratio (OR) 2.95, 95% confidence interval (CI) 2.01-4.31; P < 0.001). Of the lipomas, 21.1% were located subcutaneously, 63.6% intramuscularly and 15.2% intermuscularly. On the other hand, none of the ALTs were located subcutaneously, the majority was located intermuscularly (87.3%) and a small number of ALTs was located intramuscularly (12.7%). CONCLUSIONS: Our results suggest that using specific morphological MR imaging characteristics (maximum tumor diameter, thick septa and contrast enhancement) and the information on the localization of the lipomatous tumor, a high sensitivity and substantial specificity can be achieved for the diagnosis of lipomas and ALTs. FAU - Knebel, Carolin AU - Knebel C AUID- ORCID: 0000-0003-2594-2419 AD - Department of Orthopedics and Sports Orthopedics, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany. carolin.knebel@tum.de. FAU - Neumann, Jan AU - Neumann J AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Schwaiger, Benedikt J AU - Schwaiger BJ AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Karampinos, Dimitris C AU - Karampinos DC AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Pfeiffer, Daniela AU - Pfeiffer D AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Specht, Katja AU - Specht K AD - Institute of Pathology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Lenze, Ulrich AU - Lenze U AD - Department of Orthopedics and Sports Orthopedics, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - von Eisenhart-Rothe, Rudiger AU - von Eisenhart-Rothe R AD - Department of Orthopedics and Sports Orthopedics, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Rummeny, Ernst J AU - Rummeny EJ AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Woertler, Klaus AU - Woertler K AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. FAU - Gersing, Alexandra S AU - Gersing AS AD - Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20190403 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 RN - EC 2.3.2.27 (MDM2 protein, human) RN - EC 2.3.2.27 (Proto-Oncogene Proteins c-mdm2) MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Diagnosis, Differential MH - Female MH - *Gene Amplification MH - Humans MH - In Situ Hybridization, Fluorescence MH - Lipoma/*diagnostic imaging/genetics MH - Liposarcoma/*diagnostic imaging/genetics MH - Magnetic Resonance Imaging/methods MH - Male MH - Middle Aged MH - Proto-Oncogene Proteins c-mdm2/*genetics MH - Retrospective Studies MH - Sensitivity and Specificity MH - Young Adult PMC - PMC6448188 OTO - NOTNLM OT - Atypical lipomatous tumor OT - Lipoma OT - MDM2 amplification OT - Magnetic resonance imaging COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The Institutional Review Board (IRB) at the Klinikum rechts der Isar approved the study. Each author certifies that all investigations were conducted in conformity with the ethical principles. Written informed consent was obtained from all patients included in the study. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no financial or non-financial competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2019/04/05 06:00 MHDA- 2019/07/30 06:00 PMCR- 2019/04/03 CRDT- 2019/04/05 06:00 PHST- 2018/09/12 00:00 [received] PHST- 2019/03/26 00:00 [accepted] PHST- 2019/04/05 06:00 [entrez] PHST- 2019/04/05 06:00 [pubmed] PHST- 2019/07/30 06:00 [medline] PHST- 2019/04/03 00:00 [pmc-release] AID - 10.1186/s12885-019-5524-5 [pii] AID - 5524 [pii] AID - 10.1186/s12885-019-5524-5 [doi] PST - epublish SO - BMC Cancer. 2019 Apr 3;19(1):309. doi: 10.1186/s12885-019-5524-5.