Algarin Yanci A, Pulumati Anika, Tan Jiali, Zeitouni Nathalie C
Eastern Virginia Medical School, Norfolk, Virginia, USA.
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Australas J Dermatol. 2024 Dec;65(8):610-620. doi: 10.1111/ajd.14366. Epub 2024 Oct 3.
Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma characterized by an asymmetric, infiltrative growth pattern and a high risk of local recurrence. This study aims to evaluate the effectiveness of various imaging modalities in the assessment and management of DFSP. Nine imaging modalities were reviewed including: Ultrasound (US), High-Frequency Doppler Ultrasound (HFUS), Computed tomography (CT), Positron emission tomography-computed tomography (PET-CT), and Magnetic Resonance Imaging (MRI), High-resolution-MRI (HR-MRI), Magnetic Resonance Spectroscopy (MRS), Optical Coherence Tomography (OCT), and Dermatoscopy. Imaging is mainly used for preoperative assessment and surgical planning, not routine diagnosis. US is effective for initial evaluations, demonstrating superior ability in detecting muscle invasion and defining tumour boundaries (sensitivity - 81.8%, specificity - 100%). MRI is valuable for preoperative evaluation, surgical planning, and monitoring DFSP recurrence. It more accurately assesses tumour depth than palpation, with a sensitivity of 67% and specificity of 100%, but was inferior when compared to US. CT is utilized in cases of suspected bone involvement or pulmonary metastasis. For advanced or recurrent DFSP, PET-CT helps manage treatment responses and imatinib therapy. Emerging technologies like MRS and OCT show potential in improving diagnostic accuracy and defining surgical margins, though more data are needed. US, MRI, and CT are the primary imaging modalities for DFSP. Emerging technologies like HR-MRI, PET-CT, MRS, and OCT hold promise for refining diagnostic and management strategies. Integrating multiple technologies could enhance management, particularly in atypical or aggressive cases. Further studies are required to refine imaging protocols and improve DFSP outcomes.
隆突性皮肤纤维肉瘤（DFSP）是一种罕见的软组织肉瘤，其特征为不对称、浸润性生长模式以及局部复发风险高。本研究旨在评估各种成像方式在DFSP评估和管理中的有效性。回顾了九种成像方式，包括：超声（US）、高频多普勒超声（HFUS）、计算机断层扫描（CT）、正电子发射断层扫描-计算机断层扫描（PET-CT）、磁共振成像（MRI）、高分辨率MRI（HR-MRI）、磁共振波谱（MRS）、光学相干断层扫描（OCT）和皮肤镜检查。成像主要用于术前评估和手术规划，而非常规诊断。超声对初始评估有效，在检测肌肉侵犯和界定肿瘤边界方面表现出卓越能力（敏感性-81.8%，特异性-100%）。MRI对术前评估、手术规划和监测DFSP复发具有重要价值。它比触诊更准确地评估肿瘤深度，敏感性为67%，特异性为100%，但与超声相比则较差。CT用于怀疑有骨受累或肺转移的病例。对于晚期或复发性DFSP，PET-CT有助于管理治疗反应和伊马替尼治疗。像MRS和OCT这样的新兴技术在提高诊断准确性和界定手术切缘方面显示出潜力，不过还需要更多数据。超声、MRI和CT是DFSP的主要成像方式。像HR-MRI、PET-CT、MRS和OCT这样的新兴技术有望完善诊断和管理策略。整合多种技术可加强管理，尤其是在非典型或侵袭性病例中。需要进一步研究来完善成像方案并改善DFSP的治疗结果。
