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

Alberto Tagliafico, Mauro Truini, Bruno Spina, Paolo Cambiaso, Federico Zaottini, Bianca Bignotti, Massimo Calabrese, Lorenzo E. Derchi, Carlo Martinoli

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)2764-2770
Number of pages7
JournalEuropean Radiology
Volume25
Issue number9
DOIs
Publication statusPublished - Sep 10 2015

Keywords

  • Accuracy
  • MR imaging
  • Sarcoma
  • Sensitivity
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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