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Published in: European Radiology 6/2010

01-06-2010 | Musculoskeletal

Assessment of vascular invasion by bone and soft tissue tumours of the limbs: usefulness of MDCT angiography

Authors: Fabrice S. Thévenin, Jean-Luc Drapé, David Biau, Raphaël Campagna, Delphine Richarme, Henri Guerini, Alain Chevrot, Frédérique Larousserie, Antoine Babinet, Philippe Anract, Antoine Feydy

Published in: European Radiology | Issue 6/2010

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Abstract

Objective

To evaluate the accuracy of computed tomography angiography (CTA) in predicting arterial encasement by limb tumours, by comparing CTA with surgical findings (gold standard).

Methods

Preoperative CTA images of 55 arteries in 48 patients were assessed for arterial status: cross-sectional CTA images were scored as showing a fat plane between artery and tumour (score 0), slight contact between artery and tumour (score 1), partial arterial encasement (score 2) or total arterial encasement (score 3). Reformatted CTA images were assessed for arterial displacement, rigid wall, stenosis or occlusion. At surgery, arteries were classified as free or surgically encased; 45 arteries were free and 10 were surgically encased.

Results

Multivariate logistic regression identified the axial CTA score as a relevant predictor for arterial encasement and subsequent vascular intervention during surgery. All sites where CTA showed a fat plane between the tumour and the artery were classified as free at surgery (n = 28/28). The sensitivity of total arterial encasement on CTA (score 3) was 90%, specificity 93%, accuracy 93% and positive likelihood ratio 13.5.

Conclusion

CTA evidence of total arterial encasement is a highly specific indication of arterial encasement. The presence of fat between the tumour and the artery on CTA rules out arterial involvement at surgery.
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Metadata
Title
Assessment of vascular invasion by bone and soft tissue tumours of the limbs: usefulness of MDCT angiography
Authors
Fabrice S. Thévenin
Jean-Luc Drapé
David Biau
Raphaël Campagna
Delphine Richarme
Henri Guerini
Alain Chevrot
Frédérique Larousserie
Antoine Babinet
Philippe Anract
Antoine Feydy
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1678-x

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