title: Computed tomography of pulmonary metastases from osteosarcoma: the less poor technique. A study of 51 patients with histological correlation.
abstract: BACKGROUND
  The purpose is to evaluate the accuracy of computed tomography (CT) in the pulmonary staging of osteosarcoma.
  
  
  METHODS
  Fifty-one patients presenting with osteosarcoma and at initial CT considered metastatic to the chest had lung surgery. Two teams of two senior radiologists independently reviewed all CT examinations. Their results were compared to the histological studies.
  
  
  RESULTS
  One hundred nineteen CT's were reviewed. The 2 teams found 247 and 268 nodules on the initial. and 143 and 146 nodules on the preoperative CT. Histological studies confirmed metastatic nodules in 29 patients. Two hundred four nodules were excised and studied. One hundred nine were metastases. The 22 patients without metastases had 53 negative nodules removed. In the 29 patients with metastases, 151 nodules were removed, and 42 were non-metastatic. The positive predictive value was 53% with regard to 'nodules', and 57% with regard to 'patients'. Only 4 out of 13 patients with one nodule at surgery were metastatic, but all patients with more than 7 nodules were metastatic. The 46 cases with several available CT's, showed that no change in the number of nodules was more frequent in benign lesions. Other criteria revealed no significant difference.
  
  
  CONCLUSIONS
  CT positive predictive value is limited, but as surgery is the only way to cure metastatic patients, CT will still be used as the reference technique until a more specific approach can be found.
authors.affiliation: Department of Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Picci
authors.forename: D
authors.initials: D
authors.lastname: Vanel
authors.forename: A
authors.initials: A
authors.lastname: Briccoli
authors.forename: K
authors.initials: K
authors.lastname: Talle
authors.forename: U
authors.initials: U
authors.lastname: Haakenaasen
authors.forename: C
authors.initials: C
authors.lastname: Malaguti
authors.forename: C
authors.initials: C
authors.lastname: Monti
authors.forename: C
authors.initials: C
authors.lastname: Ferrari
authors.forename: G
authors.initials: G
authors.lastname: Bacci
authors.forename: G
authors.initials: G
authors.lastname: Saeter
authors.forename: T A
authors.initials: TA
authors.lastname: Alvegard
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology*; D002648:Child; D005189:False Positive Reactions; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000556:secondary; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed