title: Accuracy and role of contrast-enhanced CT in diagnosis and surgical planning in 88 soft tissue tumours of extremities.
abstract: OBJECTIVE
  Soft tissue tumours (STT) require accurate diagnosis in order to identify potential malignancies. Preoperative planning is fundamental to avoid inadequate treatments. The role of contrast-enhanced computed tomography (CT) for local staging remains incompletely assessed. Aims of the study were to evaluate CT accuracy in discriminating active from aggressive tumours compared to histology and evaluate the role of CT angiography (CTA) in surgical planning.
  
  
  METHODS
  This retrospective cohort series of 88 cases from 1200 patients (7 %) was locally studied by contrast-enhanced CT and CTA in a referral centre: 74 malignant tumours, 14 benign lesions. Contrast-enhancement patterns and relationship of the mass with major vessels and bone were compared with histology on surgically excised samples. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were evaluated in discriminating active from aggressive tumours.
  
  
  RESULTS
  Sensitivity in differentiating aggressive tumours from active lesions was 89 %, specificity 84 %, PPV 90 %, NPV 82 %. The relationship between mass and major vessels/bone was fundamental for surgical strategy respectively in 40 % and in 58 % of malignant tumours.
  
  
  CONCLUSIONS
  Contrast-enhanced CT and CTA are effective in differentiating aggressive masses from active lesions in soft tissue and in depicting the relationship between tumour and adjacent bones and major vessels.
  
  
  CONCLUSIONS
  • Accurate delineation of vascular and bony involvement preoperatively is fundamental for a correct resection. • CT plays a critical role in differential diagnosis of soft tissue masses. • Contrast-enhanced CT and CT angiography are helpful in depicting tumoral vascular involvement. • CT is optimal for characterization of bone involvement in soft tissue malignancies.
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy. luciabiancaverga@gmail.com.
authors.forename: Lucia
authors.initials: L
authors.lastname: Verga
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.|Department of Public Health and Paediatrics, University of Turin, Via Santena 5-bis, 10126, Torino, Italy.
authors.forename: Elena Maria
authors.initials: EM
authors.lastname: Brach Del Prever
authors.affiliation: Department of Pathology, Azienda Ospedaliera Città della Salute e della Scienza, Regina Margherita Hospital, Piazza Polonia, 10126, Torino, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Linari
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Robiati
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Armanda
authors.initials: A
authors.lastname: De Marchi
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Martorano
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Boffano
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Piana
authors.affiliation: Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126, Torino, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Faletti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods; D003287:Contrast Media; D003937:Diagnosis, Differential; D005121:Extremities / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: CT angiography; Contrast-enhanced CT; Soft tissue sarcoma; Surgical planning; Tumour vascularization