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European Radiology
Published in: European Radiology 7/2016

01-07-2016 | Musculoskeletal

Accuracy and role of contrast-enhanced CT in diagnosis and surgical planning in 88 soft tissue tumours of extremities

Authors: Lucia Verga, Elena Maria Brach del Prever, Alessandra Linari, Sara Robiati, Armanda De Marchi, Domenico Martorano, Michele Boffano, Raimondo Piana, Carlo Faletti

Published in: European Radiology | Issue 7/2016

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Abstract

Objectives

Soft tissue tumours (STT) require accurate diagnosis in order to identify potential malignancies. Preoperative planning is fundamental to avoid inadequate treatments. The role of contrast-enhanced computed tomography (CT) for local staging remains incompletely assessed. Aims of the study were to evaluate CT accuracy in discriminating active from aggressive tumours compared to histology and evaluate the role of CT angiography (CTA) in surgical planning.

Materials and methods

This retrospective cohort series of 88 cases from 1200 patients (7 %) was locally studied by contrast-enhanced CT and CTA in a referral centre: 74 malignant tumours, 14 benign lesions. Contrast-enhancement patterns and relationship of the mass with major vessels and bone were compared with histology on surgically excised samples. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were evaluated in discriminating active from aggressive tumours.

Results

Sensitivity in differentiating aggressive tumours from active lesions was 89 %, specificity 84 %, PPV 90 %, NPV 82 %. The relationship between mass and major vessels/bone was fundamental for surgical strategy respectively in 40 % and in 58 % of malignant tumours.

Conclusion

Contrast-enhanced CT and CTA are effective in differentiating aggressive masses from active lesions in soft tissue and in depicting the relationship between tumour and adjacent bones and major vessels.

Key Points

• Accurate delineation of vascular and bony involvement preoperatively is fundamental for a correct resection.
• CT plays a critical role in differential diagnosis of soft tissue masses.
• Contrast-enhanced CT and CT angiography are helpful in depicting tumoral vascular involvement.
• CT is optimal for characterization of bone involvement in soft tissue malignancies.
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Metadata
Title
Accuracy and role of contrast-enhanced CT in diagnosis and surgical planning in 88 soft tissue tumours of extremities
Authors
Lucia Verga
Elena Maria Brach del Prever
Alessandra Linari
Sara Robiati
Armanda De Marchi
Domenico Martorano
Michele Boffano
Raimondo Piana
Carlo Faletti
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4047-y

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