title: Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  • 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.
authors: Institute of Anatomy, Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16138, Genoa, Italy, alberto.tagliafico@unige.it.
authors: Alberto
authors: A
authors: Tagliafico
authors: Mauro
authors: M
authors: Truini
authors: Bruno
authors: B
authors: Spina
authors: Paolo
authors: P
authors: Cambiaso
authors: Federico
authors: F
authors: Zaottini
authors: Bianca
authors: B
authors: Bignotti
authors: Massimo
authors: M
authors: Calabrese
authors: Lorenzo E
authors: LE
authors: Derchi
authors: Carlo
authors: C
authors: Martinoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005121:Extremities / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D012008:Recurrence; D015203:Reproducibility of Results; D012509:Sarcoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult