Myxofibrosarcoma: Prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging Journal Article


Authors: Lefkowitz, R. A.; Landa, J.; Hwang, S.; Zabor, E. C.; Moskowitz, C. S.; Agaram, N. P.; Panicek, D. M.
Article Title: Myxofibrosarcoma: Prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging
Abstract: Objective: Myxofibrosarcoma frequently shows curvilinear extensions of high T2 signal that also enhance on magnetic resonance imaging; these "tails" represent fascial extension of tumor at histopathological examination. This study was performed to determine whether the tail sign is helpful in distinguishing myxofibrosarcoma from other myxoid-containing neoplasms. Materials and methods: The study group consisted of 44 patients with pathologically proven myxofibrosarcoma; the control group consisted of 52 patients with a variety of other myxoid-predominant tumors. Three musculoskeletal radiologists independently evaluated T2-weighted (and/or short-tau inversion recovery) and post-contrast MR images for the presence of one or more enhancing, high-signal intensity, curvilinear projections from the primary mass. Sensitivity and specificity for the diagnosis of myxofibrosarcoma were calculated for each reader. Interobserver variability was assessed with kappa statistic and percentage agreement. Results: A tail sign was deemed present in 28, 30, and 34 cases of myxofibrosarcoma and in 11, 9, and 5 of the controls for the three readers respectively, yielding a sensitivity of 64-77 % and a specificity of 79-90 %. The interobserver agreement was moderate-to-substantial (kappa = 0.626). Conclusion: The tail sign at MRI is a moderately specific and sensitive sign for the diagnosis of myxofibrosarcoma relative to other myxoid-containing tumors. © 2013 ISS.
Keywords: adult; clinical article; controlled study; aged; aged, 80 and over; middle aged; nuclear magnetic resonance imaging; magnetic resonance imaging; preoperative evaluation; sensitivity and specificity; reproducibility of results; tumor localization; diagnosis, differential; observer variation; prevalence; retrospective study; risk assessment; sarcoma; fibrosarcoma; diagnostic value; contrast enhancement; fibroma; malignant fibrous histiocytoma; synovial sarcoma; new york; nerve sheath tumor; neurofibroma; perfusion weighted imaging; soft tissue tumor; myxoma; myxosarcoma; neurilemoma; diagnostic test accuracy study; magnetic resonance imaging (mri); myxoid; myxofibrosarcoma
Journal Title: Skeletal Radiology
Volume: 42
Issue: 6
ISSN: 0364-2348
Publisher: Springer  
Date Published: 2013-06-01
Start Page: 809
End Page: 818
Language: English
DOI: 10.1007/s00256-012-1563-6
PROVIDER: scopus
PUBMED: 23318907
PMCID: PMC4082187
DOI/URL:
Notes: --- - "Export Date: 1 July 2013" - "CODEN: SKRAD" - "Source: Scopus"
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MSK Authors
  1. David M Panicek
    116 Panicek
  2. Narasimhan P Agaram
    118 Agaram
  3. Chaya S. Moskowitz
    174 Moskowitz
  4. Jonathan Landa
    21 Landa
  5. Sinchun Hwang
    52 Hwang
  6. Emily Craig Zabor
    136 Zabor