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Can Experienced Observers Differentiate between Lipoma and Well-Differentiated Liposarcoma Using Only MRI?
[well-differentiated liposarcoma]
Well-differentiated
liposarcoma
represents
a
radiographic
diagnostic
dilemma
.
To
determine
the
accuracy
,
interrater
reliability
,
and
relationship
of
stranding
,
nodularity
,
and
size
in
the
MRI
differentiation
of
lipoma
and
well-differentiated
liposarcoma
,
MRI
scans
of
60
patients
with
large
(
>
5
 
cm
)
,
deep
,
pathologically
proven
lipomas
or
well-differentiated
liposarcomas
were
examined
by
10
observers
with
subspecialty
training
blinded
to
diagnosis
.
Observers
indicated
whether
the
amount
of
stranding
,
nodularity
,
and
size
of
each
tumor
suggested
a
benign
or
malignant
diagnosis
and
rendered
a
diagnosis
of
lipoma
or
well-differentiated
liposarcoma
.
The
accuracy
,
reliability
,
and
relationship
of
stranding
,
nodularity
,
and
size
to
diagnosis
were
calculated
for
all
samples
.
69
%
of
reader
MRI
diagnoses
agreed
with
final
pathology
diagnosis
(
95
%
CI
65
-
73
%
)
.
Readers
tended
to
err
choosing
a
diagnosis
of
liposarcoma
,
correctly
identifying
lipomas
in
63
%
of
cases
(
95
%
CI
58
-
69
%
)
and
liposarcomas
in
75
%
of
cases
(
95
%
CI
69
-
80
%
)
.
Assessment
of
the
relationship
of
stranding
,
nodularity
,
and
size
to
correct
diagnosis
showed
that
the
presence
of
each
was
associated
with
a
decreased
likelihood
of
a
lipoma
pathological
diagnosis
(
P
<
0
.
01
)
.
While
the
radiographic
diagnosis
of
lipoma
or
well-differentiated
liposarcoma
can
not
be
made
with
100
%
certainty
,
experienced
observers
have
a
69
%
chance
of
rendering
a
correct
diagnosis
.
Diseases
Validation
Diseases presenting
"correctly identifying lipomas in 63%"
symptom
well-differentiated liposarcoma
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