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. 2020 Mar 10;15(3):e0229983. doi: 10.1371/journal.pone.0229983

Fig 4. MRI of osteoblastic osteosarcoma and applying ADC values derived from single-section ROI can complement diagnostic ability.

Fig 4

(A) Axial fat-suppressed (FS) contrast-enhanced T1-weighted image (T1WI) before treatment shows a tumor in proximal tibia with extraosseous lesion (thick arrow). (B) DWI (b of 800 sec/mm2) with ADC map before treatment shows 2D ADCminimum and 2D ADCmean of 880μm2/sec and 1179μm2/sec, respectively. (C) ADC histogram derived from whole-tumor volume before treatment shows 3D ADCmean of 1472μm2/sec, 3D ADCskewness of 0.55, and 3D ADCkurtosis of 2.26. (D) Axial FS contrast-enhanced T1WI after treatment shows marked decrease in extraosseous lesion (thick arrow) with heterogeneously enhancement (thin arrow), interpreted as good responder in reader 2. (E) DWI with ADC map after treatment shows 2D ADCminimum and 2D ADCmean of 1047μm2/sec and 1395μm2/sec, respectively, indicating a poor responder. (F) ADC histogram derived from whole-tumor volume after treatment shows 3D ADCmean of 1500μm2/sec, 3D ADCskewness of 0.10, and 3D ADCkurtosis of 3.15. The percent change of 2D ADCminimum and 2D ADCmean presents as 19.0% and 18.3%, respectively. The histopathology demonstrates a poor treatment response (necrosis = 32%).