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Objective <p>The goal of this study is to compare the sensitivity, accuracy, and specificity of detection of musculoskeletal sarcoma local recurrence (LR) using axial-only MRI compared with multiplanar MRI.</p> Materials and methods <p>This retrospective study included 101 patients (47 with pathology-proven LR, 54 without recurrence) who underwent pre- and post-operative MRIs between 2013 and 2023 at a single academic center. Three fellowship-trained musculoskeletal radiologists independently reviewed anonymized MRIs. Initial review included only the axial sequences from the surveillance MRIs. Secondary review following a 6-month washout included all sequences from the multiplanar surveillance MRIs.</p> Results <p>No statistically significant differences in accuracy, sensitivity, and specificity were observed between axial-only and complete (multiplanar) MRI analyses (<i>p</i> &gt; 0.05). Accuracy of LR detection with axial-only vs. complete (multiplanar) MRI was 94.5% vs. 93.1% (Reader 1), 87.1% vs. 91.1% (Reader 2), and 82.7% vs. 86.1% (Reader 3). LR size ranged from 0.7 to 8.9&#xa0;cm (mean 3.2&#xa0;cm, median 2.6&#xa0;cm). All missed recurrences when using axial-only surveillance MRI measured &lt; 2&#xa0;cm. Inter-reader agreement improved from 0.768 (axial-only) to 0.834 (complete MRI).</p> Conclusion <p>Surveillance MRI using axial sequences alone demonstrated comparable accuracy, sensitivity, and specificity to multiplanar MRI for detecting musculoskeletal sarcoma LR.</p>

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MRI surveillance for musculoskeletal sarcoma recurrence: is axial-only imaging good enough?

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Arora Manasi,
  • Ronnie A. Sebro,
  • Benjamin K. Wilke,
  • Hillary W. Garner,
  • Jeffrey J. Peterson,
  • Rupert O. Stanborough

摘要

Objective

The goal of this study is to compare the sensitivity, accuracy, and specificity of detection of musculoskeletal sarcoma local recurrence (LR) using axial-only MRI compared with multiplanar MRI.

Materials and methods

This retrospective study included 101 patients (47 with pathology-proven LR, 54 without recurrence) who underwent pre- and post-operative MRIs between 2013 and 2023 at a single academic center. Three fellowship-trained musculoskeletal radiologists independently reviewed anonymized MRIs. Initial review included only the axial sequences from the surveillance MRIs. Secondary review following a 6-month washout included all sequences from the multiplanar surveillance MRIs.

Results

No statistically significant differences in accuracy, sensitivity, and specificity were observed between axial-only and complete (multiplanar) MRI analyses (p > 0.05). Accuracy of LR detection with axial-only vs. complete (multiplanar) MRI was 94.5% vs. 93.1% (Reader 1), 87.1% vs. 91.1% (Reader 2), and 82.7% vs. 86.1% (Reader 3). LR size ranged from 0.7 to 8.9 cm (mean 3.2 cm, median 2.6 cm). All missed recurrences when using axial-only surveillance MRI measured < 2 cm. Inter-reader agreement improved from 0.768 (axial-only) to 0.834 (complete MRI).

Conclusion

Surveillance MRI using axial sequences alone demonstrated comparable accuracy, sensitivity, and specificity to multiplanar MRI for detecting musculoskeletal sarcoma LR.