# Role of Dynamic Contrast-Enhanced MRI in Detecting Post-Treatment Local Recurrence of Soft-Tissue Sarcomas: A Systematic Review and Meta-Analysis

## TL;DR

This study shows that adding dynamic contrast-enhanced MRI improves accuracy in detecting soft-tissue sarcoma recurrence after treatment.

## Contribution

The novel contribution is demonstrating that DCE-MRI combined with conventional MRI significantly improves diagnostic accuracy for local sarcoma recurrence.

## Key findings

- DCE-MRI qualitative features and quantitative parameters consistently differentiate local recurrence from post-treatment changes.
- Combined DCE-MRI and conventional MRI achieved 98% sensitivity and 83% specificity for recurrence detection.
- The SROC area under the curve was 0.94, indicating high diagnostic accuracy.

## Abstract

Background: The role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in detecting soft-tissue sarcoma (STS) local recurrence (LR) following therapeutic intervention was evaluated. Method: PubMed, Embase, and Scopus were systematically searched from January 1990 to 1 February 2024 for studies evaluating DCE-MRI for LR detection in histologically confirmed STS following surgery. Two independent reviewers screened studies and extracted data, and a bivariate diagnostic test accuracy meta-analysis was performed to estimate pooled sensitivity, specificity, and the area under the summary receiver operating characteristic (SROC) curve. Results: Six studies, including 309 patients (110 with LR and 199 without LR), met the inclusion criteria. Across studies, DCE-MRI qualitative features (such as early rapid arterial enhancement and malignant time–intensity curves) and quantitative or semiquantitative parameters (such as volume transfer constants [Ktrans and Kep], initial area under the curve [iAUC], and relative plasma flow [rPF]) consistently differentiated LR from post-treatment change. When DCE-MRI parameters were added to conventional MRI, the pooled sensitivity and specificity for LR detection were 98% and 83%, respectively, with an SROC area under the curve of 0.94, indicating high overall diagnostic accuracy. Conclusions: DCE-MRI increases the accuracy of LR detection when combined with conventional MRI and offers a higher specificity and sensitivity in distinguishing LR from post-surgical changes, which support consideration of adding DCE-MRI when LR is suspected; prospective standardized studies are warranted.