title: CT scans for pulmonary surveillance may be overused in lower-grade sarcoma.
abstract: Chest CT scans are often used to monitor patients after excision of a sarcoma. Although sensitive, CT scans are more expensive than chest radiographs and are associated with possible health risks from a higher radiation dose. We hypothesized that a program based upon limited CT scans in lower-grade sarcoma could be efficacious and less expensive. We retrospectively assigned patients to a high-risk or low-risk hypothetical protocol. Eighty-three low- or intermediate-grade soft tissue sarcomas met our inclusion criteria. Eight patients had pulmonary metastasis. A protocol based on selective CT scans for high-risk patients would have identified seven out of eight lesions. The incremental cost-effectiveness ratio for routine CT scans was $731,400. A program based upon selective CT scans for higher-risk patients is accurate, spares unnecessary radiation to many patients, and is less expensive.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, 01025 JPP Iowa City, IA 52242, USA. benjamin-j-miller@uiowa.edu
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Miller
authors.forename: Emily E
authors.initials: EE
authors.lastname: Carmody Soni
authors.forename: John D
authors.initials: JD
authors.lastname: Reith
authors.forename: C Parker
authors.initials: CP
authors.lastname: Gibbs
authors.forename: Mark T
authors.initials: MT
authors.lastname: Scarborough
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000556:secondary; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult