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18F-FDG PET/CT and MRI features of myxoid liposarcomas and intramuscular myxomas

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Abstract

Objective

To examine the imaging characteristics of intramuscular myxomas (IM) and myxoid liposarcomas (MLS) on 18F-FDG PET/CT and MRI.

Materials and methods

With IRB approval, our institutional imaging database was searched for pathologically proven IM and MLS evaluated by 18F-FDG PET/CT and MRI. PET/CT and MRI imaging characteristics were recorded and correlated with pathologic diagnosis.

Results

We found eight patients (2 M, 6 F) with IM (mean age 65.6 ± 10.4 years) and 16 patients (7 F, 9 M) with MLS (mean age 42.8 ± 16.3 years). MRI was available in 7/8 IM and 15/16 MLS patients. There was no significant difference between the two groups in SUVmax (IM 2.7 ± 0.8, MLS 3.0 ± 1.0; p = 0.35), SUVmean (1.7 ± 0.4, 1.5 ± 0.5; p = 0.40), total lesion glycolysis (101.8 ± 127.3, 2420.2 ± 4003.3 cm3*g/ml; p = 0.12), metabolic tumor volume (62.3 ± 71.1, 1742.9 ± 3308.0 cm3; p = 0.17) or CT attenuation (p = 0.70). MLS occurred in younger patients (p = 0.0015), were larger (16.4 ± 8.2 vs. 5.6 ± 2.5 cm; p = 0.0015), more often T1 hyperintense (p = 0.03), with nodular enhancement (p = 0.006), and macroscopic fat on CT (p = 0.0013) and MRI (p = < 0.001) compared to myxomas.

Conclusions

IM and MLS most commonly demonstrate low-grade FDG activity and overlapping metabolic measures on PET/CT. MRI is useful in differentiation, but MLS can present without macroscopic fat on MRI, underscoring the importance of radiologic-pathologic correlation for accurate diagnosis.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Brendan W. Lunn, Laurel A. Littrell, Doris E. Wenger & Stephen M. Broski

Authors
  1. Brendan W. Lunn
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  2. Laurel A. Littrell
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  3. Doris E. Wenger
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  4. Stephen M. Broski
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Correspondence to Stephen M. Broski.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflicts of interest.

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Lunn, B.W., Littrell, L.A., Wenger, D.E. et al. 18F-FDG PET/CT and MRI features of myxoid liposarcomas and intramuscular myxomas. Skeletal Radiol 47, 1641–1650 (2018). https://doi.org/10.1007/s00256-018-3000-y

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  • DOI: https://doi.org/10.1007/s00256-018-3000-y

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