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Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound

  • Musculoskeletal
  • Published:
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Abstract

Objectives

To evaluate diagnostic performance of ultrasound in the detection of local recurrences in patients with localized soft tissue sarcomas of the limb.

Methods

An analysis of patients treated for soft tissue sarcomas between 2005 and April 2014 was performed. Sixty-eight patients (men/women, 36:32; age range, 18–84 years) were evaluated. Sensitivity, specificity with 95 % confidence intervals (CIs), positive predictive value (PPV), pre-test probability (the prevalence), negative predictive value (NPV), likelihood ratio for positive results (LH+), accuracy and post-test probability (post-P) of ultrasound were reported on a per patient basis using surgical findings and clinical follow-up as reference standard. Effects of independent variables (US equipment, age and sex, body mass index, radiologist) were considered. Comparison with MR was also performed.

Results

The overall sensitivity and specificity were 0.88 (0.60–0.94) and 0.94 (0.86–0.98). PPV, pre-test probability, NPV, LH+, accuracy and post-P: 0.83/0.25/0.96/14.9/0.92/0.83. There were two false negative cases both graded as G3 and deeply located and three false positive US cases. Diagnostic accuracy was not dependent by US machine (p = 0.08), age and sex (p = 0.16), body mass index (p = 0.07) and radiologists (p = 0.07).

Conclusions

Diagnostic accuracy of ultrasound was relatively high. Negative US results excluded the presence of a local recurrence with acceptable accuracy.

Key points

• US accuracy is relatively high in sarcoma follow-up.

• Negative US results exclude the presence of local recurrence with acceptable accuracy.

• US may miss a small proportion of lesions.

• False positive US cases are rare.

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Acknowledgments

The scientific guarantor of this publication is Alberto Tagliafico, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Prof. Maria Pia Sormani kindly provided statistical advice for this manuscript. And one of the authors has significant statistical expertise. Institutional review board approval was not deemed necessary owing to the retrospective nature of the study. Written informed consent was obtained from all subjects (patients) in this study. Methodology: observational, monocentric. The project was awarded at ESSR (European Society of Musculoskeletal Radiology) 2014: ESSR Young Researchers Grant to Dr. Bianca Bignotti on occasion of the Annual Scientific Meeting 2014 in Riga, Latvia. The project is partially supported by the AIUM (American Institute of Ultrasound in Medicine) Endowment for Education and Research (EER) with a grant to Alberto Tagliafico. The study is partially supported by the University of Genova with a grant (PRA) to Carlo Martinoli.

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Authors and Affiliations

  1. Institute of Anatomy, Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16138, Genoa, Italy

    Alberto Tagliafico

  2. Department of Pathology, Istituto di Ricovero e Cura a Carattere Scientitifico Azienda Ospedaliera Universitaria San Martino–Istituto Nazionale per la Ricerca sul Cancro (IRCCS AOU San Martino–IST), Genova, Italy

    Mauro Truini & Bruno Spina

  3. School of Medicine, Genova, Italy

    Paolo Cambiaso & Federico Zaottini

  4. Department of Health Sciences (DISSAL), University of Genoa, Largo Rosanna Benzi 8, 16132, Genoa, Italy

    Bianca Bignotti, Lorenzo E. Derchi & Carlo Martinoli

  5. Department of Radiology, IRCCS AOU San Martino-IST, Genoa, Italy

    Alberto Tagliafico & Massimo Calabrese

  6. Department of Experimental Medicine –DIMES, University of Genoa, Via Leon Battista Alberti, 2, 16132, Genoa, Italy

    Alberto Tagliafico

Authors
  1. Alberto Tagliafico
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  2. Mauro Truini
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  3. Bruno Spina
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  4. Paolo Cambiaso
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  5. Federico Zaottini
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  6. Bianca Bignotti
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  7. Massimo Calabrese
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  8. Lorenzo E. Derchi
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  9. Carlo Martinoli
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Correspondence to Alberto Tagliafico.

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Tagliafico, A., Truini, M., Spina, B. et al. Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound. Eur Radiol 25, 2764–2770 (2015). https://doi.org/10.1007/s00330-015-3645-z

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  • DOI: https://doi.org/10.1007/s00330-015-3645-z

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