title: Assessment of vascular invasion by bone and soft tissue tumours of the limbs: usefulness of MDCT angiography.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology B, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France. fabricethevenin@yahoo.fr
authors.forename: Fabrice S
authors.initials: FS
authors.lastname: Thévenin
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Drapé
authors.forename: David
authors.initials: D
authors.lastname: Biau
authors.forename: Raphaël
authors.initials: R
authors.lastname: Campagna
authors.forename: Delphine
authors.initials: D
authors.lastname: Richarme
authors.forename: Henri
authors.initials: H
authors.lastname: Guerini
authors.forename: Alain
authors.initials: A
authors.lastname: Chevrot
authors.forename: Frédérique
authors.initials: F
authors.lastname: Larousserie
authors.forename: Antoine
authors.initials: A
authors.lastname: Babinet
authors.forename: Philippe
authors.initials: P
authors.lastname: Anract
authors.forename: Antoine
authors.initials: A
authors.lastname: Feydy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001859:Bone Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*