Evidence map›Paper›PMID 41526857›Full record

ArticleBMC cancer2026

Evaluation of magnetic resonance imaging parameters and compliance with guidelines in soft tissue sarcomas.

Madelaine Hettler, Josephine Kirschstein, Isabelle Ayx, Melissa Harbrücker, Franka Menge, Christoph Reißfelder, Stefan Schönberg, Dominik Nörenberg, Matthias F Froelich, Jens Jakob

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Madelaine HettlerDepartment of Surgery, Sarcoma Unit, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Josephine KirschsteinDepartment of Surgery, Sarcoma Unit, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Isabelle AyxDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Melissa HarbrückerDepartment of Surgery, Sarcoma Unit, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Franka MengeDepartment of Surgery, Sarcoma Unit, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Christoph ReißfelderDKFZ-Hector Cancer Institute, University Medical Center Mannheim, Heidelberg, Germany.
Stefan SchönbergDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Dominik NörenbergDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Matthias F FroelichDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Jens JakobDepartment of Surgery, Sarcoma Unit, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany. Jens.Jakob@umm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate imaging plays a crucial role for prognostic assessment and treatment allocation in soft tissue sarcoma (STS). Guidelines recommend contrast-enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) for tumor assessment. This study aims to evaluate the extent to which the MRI protocols used in clinical practice align with the sequences specified in the guideline in the diagnostic work-up of sarcoma patients.

methodsWe analyzed a cohort of patients treated at the Sarcoma Center of the University Medical Center Mannheim (UMM). Pretherapeutic MRI protocols were compared with the recommendations of the German sarcoma guideline.

resultsWe analyzed 64 MRI examinations of patients with STS of the extremities and trunk, notably 62 performed at external radiology centers and 2 at UMM. A pretherapeutic contrast-enhanced MRI was available in 51 of 64 cases (79.7%), of which 40 referrals explicitly indicated a soft tissue tumor. In 3.1% of the cases, the complete set of guideline-recommended sequences was not performed. At least two of the required sequences were consistently available. The most frequently absent sequences were the T1-weighted sequence without fat saturation acquired before and after contrast administration using identical acquisition parameters (82.8%) and DWI sequences (78.1%).

conclusionsMRI protocol selection is primarily guided by the clinical referral question. Our analysis indicates that a substantial proportion of examinations deviated from recommended protocols. Contributing factors may include inaccurate clinical referral questions, limited guideline awareness, reimbursement constraints in outpatient settings, or diagnostic considerations. Standardized imaging represents a key instrument for quality assurance in the diagnosis of STS and forms the foundation for clinical and translational studies. In the future, the recommendations should be re-evaluated and published in a clear, accessible format to ensure broad implementation.

Indexed as

Guideline AdherenceMagnetic Resonance ImagingSarcomaSoft Tissue NeoplasmsAdolescentAdultAgedAged, 80 and overContrast MediaDiffusion Magnetic Resonance ImagingFemaleHumansMaleMiddle AgedPractice Guidelines as TopicYoung AdultContrast MediaDiagnostic imagingMagnetic Resonance ImagingMultimodal treatmentSoft tissue sarcoma

Identifiers

PMID41526857
PMCPMC12836972

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.