Can MRI differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma? A systematic review.

Background and purpose - Adequate staging of chondroid tumors at diagnosis is important as it determines both treatment and outcome. This systematic review provides an overview of MRI criteria used to differentiate between atypical cartilaginous tumors (ACT) and high-grade chondrosarcoma (HGCS).Patients and methods - For this systematic review PubMed and Embase were searched, from inception of the databases to July 12, 2018. All original articles describing MRI characteristics of pathologically proven primary central chondrosarcoma and ACT were included. A quality appraisal of the included papers was performed. Data on MRI characteristics and histological grade were extracted by 2 reviewers. Meta-analysis was performed if possible. The study is registered with PROSPERO, CRD42018067959.Results - Our search identified 2,132 unique records, of which 14 studies were included. 239 ACT and 140 HGCS were identified. The quality assessment showed great variability in consensus criteria used for both pathologic and radiologic diagnosis. Due to substantial heterogeneity we refrained from pooling the results in a meta-analysis and reported non-statistical syntheses. Loss of entrapped fatty marrow, cortical breakthrough, and extraosseous soft tissue expansion appeared to be present more often in HGCS compared with ACT.Interpretation - This systematic review provides an overview of MRI characteristics used to differentiate between ACT and HGCS. Future studies are needed to develop and assess more reliable imaging methods and/or features to differentiate ACT from HGCS.

Multiparametric MRI of the bladder: ready for clinical routine?

OBJECTIVE: In this article, we describe the fundamentals of multiparametric MRI in bladder cancer and provide an overview of the currently available data concerning this new imaging technology. Urinary bladder cancer is a relatively common malignancy, especially in elderly patients. Treatment outcome and prognosis are strongly related to adequate local and regional tumor staging. Unfortunately, clinical understaging frequently occurs, which negatively influences prognosis. Therefore, advanced imaging techniques are needed to adequately stage bladder cancer patients. MRI is currently the best imaging technique for local and nodal staging in bladder cancer patients because of its superior soft-tissue contrast without exposure to ionizing radiation. Important improvements in MRI technology have led to the introduction of multiparametric MRI, combining anatomic and functional sequences. CONCLUSION: The first results of multiparametric MRI seem promising, especially in detection, staging, and follow-up of bladder cancer. However, more studies are needed with larger study populations to define the exact place of multiparametric MRI in bladder cancer patients.