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MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification.
[well-differentiated liposarcoma]
To
review
the
reliability
of
MR
imaging
features
for
the
purpose
of
distinguishing
lipoma
and
atypical
lipomatous
tumor
/
well-differentiated
liposarcoma
(
ALT
/
WDL
)
.
A
retrospective
review
of
87
patients
with
histologically
proven
lipomatous
tumors
was
performed
.
All
underwent
MR
imaging
,
assessing
lipomatous
content
,
septation
,
and
nodules
.
The
associations
between
these
features
and
tumor
diagnosis
based
on
morphology
and
the
presence
or
absence
of
MDM
2
amplification
were
explored
.
The
age
of
the
patient
and
the
size
and
location
of
the
lesion
were
also
recorded
for
statistical
analysis
.
Of
the
87
patients
,
54
were
classified
as
lipomas
and
33
as
ALT
/
WDL
.
MR
identified
ALT
/
WDL
with
a
sensitivity
of
90
.
9
%
(
CI
74
.
5
-
97
.
6
)
and
a
specificity
of
37
.
0
%
(
CI
24
.
6
-
51
.
3
)
.
The
positive
and
negative
predictive
values
were
46
.
9
%
(
CI
34
.
5
-
59
.
7
)
and
86
.
9
%
(
CI
65
.
3
-
96
.
6
)
,
respectively
.
The
mean
age
of
patients
with
ALT
/
WDL
was
greater
(
60
years
[
range
40
-
83
years
]
)
than
those
with
lipoma
(
52
years
[
range
10
-
79
years
]
)
(
p
=
0
.
025
)
.
The
mean
size
of
ALT
/
WDL
(
18
.
7
cm
[
range
5
-
36
cm
]
)
was
significantly
greater
than
lipoma
(
13
.
9
cm
[
range
3
-
32
cm
]
)
(
p
=
0
.
003
)
.
Features
that
increased
the
likelihood
of
ALT
/
WDL
included
:
patient
age
over
60
years
,
maximal
lesion
dimension
over
10
cm
,
location
in
lower
limb
,
and
presence
of
non-fatty
areas
,
by
a
factor
of
2
.
61
-
6
.
25
times
.
ALT
/
WDL
and
lipoma
have
overlapping
MR
imaging
characteristics
.
The
most
reliable
imaging
discriminators
of
ALT
/
WDL
were
size
of
lesion
and
lipomatous
content
,
but
due
to
the
overlap
in
the
MRI
appearances
of
lipoma
and
ALT
/
WDL
,
discrimination
should
be
based
on
molecular
pathology
rather
than
imaging
.
Diseases
Validation
Diseases presenting
"liposarcoma"
symptom
dedifferentiated liposarcoma
erdheim-chester disease
focal myositis
gm1 gangliosidosis
liposarcoma
pleomorphic liposarcoma
well-differentiated liposarcoma
This symptom has already been validated