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Background: Magnetic Resonance Imaging is the method of choice for the diagnostic work-up of soft tissue tumors. It is the modality of choice to evaluate such masses, because of its excellent soft tissue contrast. Aim of Study: To assess the efficacy of Diffusion weighted MRI in characterization of musculoskeletal soft tissue tumors. Patients and Methods: The current study enrolled 20 patients (11 female and 9 male) with musculoskeletal STTs with mean age was 41.08±11.54 year. The most frequent affected site with the swelling was the thigh (48%) followed by the arm (20%). Four (16%) patients suffered from leg swelling while three (12%) patients had shoulder swelling. Our results revealed that malignant musculoskeletal soft tissue masses had significantly lower ADC value in comparison to those with benign masses (0.70±0.09 vs. 1.58±0.52x10-3m2/s; p < 0.001). Results: Patients with malignant lesions had significantly lower ADC value in comparison to those with benign lesions (0.70±0.09 vs. 1.58±0.52 (103mm2/s). Myxoma had the highest ADC value that was 2.44 (103mm2/s) while sarcoma had lowest value that was 0.54±0.03 (103mm2/s). It was noticed that MRI had 100% sensitivity and 81.8% specificity for diagnosis of malignant musculoskeletal soft tissue masses with overall accuracy was 92% and area under curve was 0.91 at cut off value was

Background: magnetic resonance imaging (MRI) has an important role in characterization of soft tissue tumors, yet, it lacks specificity for differentiation between the benign and malignant lesions. Aim of the Work: this study aimed to evaluate the ability of DW MRI in detection and characterization of the musculoskeletal soft tissue tumors. Patients and methods: this prospective study included 30 patients (20 females and 10 males) referred to MRI unit Ain shams University Hospital for MRI evaluation of musculoskeletal soft tissue tumors. Results: from 30 cases, 12 cases were benign (40%), 18 cases malignant (60%). From 12 cases of the benign, 8 cases were ≤ 40 years and 4 cases were > 40. From 18 cases of the malignant, 7 cases were ≤ 40 and 11 cases > 40. Ranging of ADC value of benign tumors (1.72-2.58); mean ADC (2.21 ´ 10-3 mm2/sec). Ranging of ADC value of malignant tumors was 0.52-1.82. Mean ADC value was 0.90 ´ 10-3 mm2/sec. Cut-off ADC value ≤ 1.14 less than 1.14 was benign and more than 1.14 was malignant; sensitivity 94.4% and specificity 91.7%. Conclusion: DWI with ADC mapping and measurement of ADC value proved to be a valuable non –invasive tool in differentiating between benign and malignant musculoskeletal soft tissue tumors. Recommendations: a larger population for future studies is needed. Thus, histopathologic work up is required for reliable characterization of soft tissue tumors (4).