{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:58:30Z","timestamp":1790593110818,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: Although MRI is the preferred modality for evaluating suspected soft-tissue sarcomas (STSs), initial MRI reports are frequently incomplete and often fail to document key features that support diagnosis, staging, and timely referral. This study assessed the quality of initial MRI reports for STSs and identified the specific reporting characteristics most strongly associated with diagnostic correlation. Methods: A retrospective review was performed of 100 patients with histologically confirmed STSs presenting to a specialized sarcoma center between 2021 and 2024. Initial MRI reports performed externally were analyzed for 19 characteristics based on the European Society of Musculoskeletal Radiology guidelines. Reports were stratified by radiologist fellowship training. Findings were compared across groups, and individual MRI features were assessed for correlation with final histopathologic diagnosis. Results: Overall, initial MRI reporting was incomplete, with most features documented in fewer than 70% of cases. Reports by MSK radiologists were higher in quality, more often included bone involvement, peritumoral edema, and suspicion of malignancy. Diagnostic correlation was significantly greater for MSK radiologists compared to general radiologists (p = 0.027). Documentation of heterogeneity, depth, gadolinium use, necrosis, and suspicion of malignancy were all strongly associated with diagnostic correlation. Conclusions: Initial MRI reports for STSs frequently lack key diagnostic features, but MSK fellowship\u2013trained radiologists produce higher-quality reports and demonstrate stronger diagnostic concordance. Standardized reporting frameworks may ultimately improve patient care and would benefit from direct evaluation in future studies.<\/jats:p>","DOI":"10.3390\/diagnostics16193130","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:34Z","timestamp":1790589634000},"page":"3130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Initial MRI Reports for Soft-Tissue Sarcomas and Their Association with Radiologic Recognition of Sarcoma"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5542-6564","authenticated-orcid":false,"given":"Eric","family":"Kholodovsky","sequence":"first","affiliation":[{"name":"Department of Orthopedics, University of Miami, 1120 NW 14th Street, Suite 1263, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0745-7049","authenticated-orcid":false,"given":"Jacob","family":"Jahn","sequence":"additional","affiliation":[{"name":"Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneesh","family":"Samineni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Miami, 1120 NW 14th Street, Suite 1263, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-2143","authenticated-orcid":false,"given":"Sergio J.","family":"Torralbas Fitz","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Miami, 1120 NW 14th Street, Suite 1263, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5050-3982","authenticated-orcid":false,"given":"Jean","family":"Jose","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0943-1168","authenticated-orcid":false,"given":"Ty","family":"Subhawong","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7115-073X","authenticated-orcid":false,"given":"H. Thomas","family":"Temple","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Miami, 1120 NW 14th Street, Suite 1263, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4103\/ortho.IJOrtho_220_17","article-title":"Soft-tissue Sarcomas","volume":"52","author":"Vodanovich","year":"2018","journal-title":"Indian J. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.18632\/oncotarget.26809","article-title":"Sarcomas in the United States: Recent trends and a call for improved staging","volume":"10","author":"Gage","year":"2019","journal-title":"Oncotarget"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1302\/0301-620X.92B11.24326","article-title":"Earlier diagnosis of bone and soft-tissue tumours","volume":"92","author":"Grimer","year":"2010","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13569-016-0060-4","article-title":"UK guidelines for the management of soft tissue sarcomas","volume":"6","author":"Dangoor","year":"2016","journal-title":"Clin. Sarcoma Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1053\/j.sult.2011.05.001","article-title":"Imaging of soft tissue and osseous sarcomas of the extremities","volume":"32","author":"Colleran","year":"2011","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101568","DOI":"10.1016\/j.jcot.2021.101568","article-title":"Imaging update on soft tissue sarcoma","volume":"22","author":"Vibhakar","year":"2021","journal-title":"J. Clin. Orthop. Trauma."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S0030-5898(20)30869-5","article-title":"The radiology of bone and soft tissue sarcomas","volume":"8","author":"Forrester","year":"1977","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13569-016-0047-1","article-title":"UK guidelines for the management of bone sarcomas","volume":"6","author":"Gerrand","year":"2016","journal-title":"Clin. Sarcoma Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Weiss, S., Korthaus, A., Baumann, N., Yamamura, J., Spiro, A.S., Lubke, A.M., Frosch, K.H., Schlickewei, C., and Priemel, M. (2021). Musculoskeletal Soft-Tissue Sarcoma: Quality Assessment of Initial MRI Reports Shows Frequent Deviation from ESSR Guidelines. Diagnostics, 11.","DOI":"10.3390\/diagnostics11040695"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1007\/s00256-023-04555-6","article-title":"Preparing MSK radiologists of the future","volume":"53","author":"Rosenthal","year":"2024","journal-title":"Skelet. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sedaghat, S., Sedaghat, M., Meschede, J., Jansen, O., and Both, M. (2021). Diagnostic value of MRI for detecting recurrent soft-tissue sarcoma in a long-term analysis at a multidisciplinary sarcoma center. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08113-y"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Larios, F., Gonzalez, M.R., Ruiz-Arellanos, K., Aquilino, E.S.G., and Pretell-Mazzini, J. (2024). Is Unplanned Excision of Soft Tissue Sarcomas Associated with Worse Oncological Outcomes?-A Systematic Review and Meta-Analysis. Cancers, 16.","DOI":"10.3390\/cancers16020443"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e247","DOI":"10.3747\/co.20.1308","article-title":"Surgical margins and handling of soft-tissue sarcoma in extremities: A clinical practice guideline","volume":"20","author":"Kandel","year":"2013","journal-title":"Curr. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1002\/jso.24137","article-title":"Characteristics of 64 sarcoma patients referred to a sarcoma center after unplanned excision","volume":"113","author":"Dyrop","year":"2016","journal-title":"J. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Gurun, E., Ozturk, M., Basaran, M., and Okutan, A.E. (2026). Shear Wave Elastography in Musculoskeletal Imaging: A Narrative Review. J. Clin. Med., 15.","DOI":"10.3390\/jcm15124843"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.3390\/tomography8030131","article-title":"Clinical Routine and Necessary Advances in Soft Tissue Tumor Imaging Based on the ESSR Guideline: Initial Findings","volume":"8","author":"Korthaus","year":"2022","journal-title":"Tomography"},{"key":"ref_17","first-page":"3324","article-title":"Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2024: Imaging immediately after neoadjuvant therapy in soft tissue sarcoma, soft tissue tumor surveillance, and the role of interventional radiology","volume":"35","author":"Vilanova","year":"2025","journal-title":"Eur. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.2106\/00004623-198264080-00002","article-title":"The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors","volume":"64","author":"Mankin","year":"1982","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/jso.23021","article-title":"Primary excision compared with re-excision of extremity soft tissue sarcomas\u2014Is anything new?","volume":"105","author":"Alamanda","year":"2012","journal-title":"J. Surg. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1089\/jayao.2021.0110","article-title":"Treatment at Specialized Cancer Centers Is Associated with Improved Survival in Adolescent and Young Adults with Soft Tissue Sarcoma","volume":"11","author":"Alvarez","year":"2022","journal-title":"J. Adolesc. Young Adult Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S1064-9689(21)00650-4","article-title":"The role of MR imaging in soft tissue tumor evaluation: Perspective of the orthopedic oncologist and musculoskeletal pathologist","volume":"8","author":"Frassica","year":"2000","journal-title":"Magn. Reson. Imaging Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1148\/radiol.14131871","article-title":"Can MR imaging be used to predict tumor grade in soft-tissue sarcoma?","volume":"272","author":"Zhao","year":"2014","journal-title":"Radiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00590-021-03003-2","article-title":"Magnetic resonance imaging of soft tissue sarcoma: Features related to prognosis","volume":"31","author":"Scalas","year":"2021","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1148\/radiol.2019181659","article-title":"Soft-Tissue Sarcomas: Assessment of MRI Features Correlating with Histologic Grade and Patient Outcome","volume":"291","author":"Crombe","year":"2019","journal-title":"Radiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111548","DOI":"10.1016\/j.ejrad.2024.111548","article-title":"Inferring malignancy grade of soft tissue sarcomas from magnetic resonance imaging features: A systematic review","volume":"177","author":"Schmitz","year":"2024","journal-title":"Eur. J. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1016\/j.ejrad.2016.05.003","article-title":"Current utilities of imaging in grading musculoskeletal soft tissue sarcomas","volume":"85","author":"Fisher","year":"2016","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e1032","DOI":"10.1016\/j.crad.2023.08.020","article-title":"Prediction of high-grade soft-tissue sarcoma using a combined intratumoural and peritumoural MRI-based radiomics nomogram","volume":"78","author":"Dou","year":"2023","journal-title":"Clin. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.suronc.2020.04.026","article-title":"Re-excision after unplanned excision of soft tissue sarcomas: Long-term results","volume":"34","author":"Scoccianti","year":"2020","journal-title":"Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1245\/s10434-017-5776-8","article-title":"The Prognostic Impact of Unplanned Excisions in a Cohort of 728 Soft Tissue Sarcoma Patients: A Multicentre Study","volume":"24","author":"Smolle","year":"2017","journal-title":"Ann. Surg. Oncol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/19\/3130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:12:48Z","timestamp":1790590368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/19\/3130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":29,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["diagnostics16193130"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16193130","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]}}}