title: Solitary fibrous tumor of the pleura: Can computed tomography features help predict malignancy? A series of 56 patients with histopathological correlates.
abstract: OBJECTIVE
  To identify computed tomography (CT) predictors of malignancy, from a retrospective study of preoperative CT scans of patients with solitary fibrous tumors (SFT) of the pleura.
  
  
  METHODS
  The CT scans of 56 patients with histopathologically confirmed SFT (33 women and 23 men; mean age, 60years) who underwent surgery between December 2004 and November 2012 were retrospectively analyzed by three radiologists working in consensus, blinded to the final histological diagnosis.
  
  
  RESULTS
  SFT was asymptomatic and incidentally discovered in 22 patients (45.8%). Resection specimen analysis (R0 resection in all cases) revealed that 23 tumors (41%) were malignant. The CT features, which significantly differed between malignant and benign SFTs were tumor size (P=0.002) with a discriminative threshold value of 10cm, tumor heterogeneity before (P=0.02) and after (P=0.03) intravenous administration of iodinated contrast material, presence of intratumoral hydric attenuation areas (P=0.01), pleural effusion (P=0.01), measurable intratumoral vessels (P=0.02), hypervascularization with visible intratumoral vessels and/or marked enhancement (P=0.001). Presence of intratumoral calcifications (P=0.2) and maximum post-contrast enhancement value (P=0.6) were not significantly different between the two groups.
  
  
  CONCLUSIONS
  A size greater than or equal to 10cm, hypervascularization, attenuation heterogeneity and association with pleural effusion are individual variables that suggest malignant SFT on CT.
authors.affiliation: Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Hélage
authors.affiliation: Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France. Electronic address: marie-pierre.revel@aphp.fr.
authors.forename: M P
authors.initials: MP
authors.lastname: Revel
authors.affiliation: Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: M L
authors.initials: ML
authors.lastname: Chabi
authors.affiliation: Department of Biostatistics and Epidemiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: É
authors.initials: É
authors.lastname: Audureau
authors.affiliation: Department of Radiology, clinique universitaire de radiologie et imagerie médicale, CHU de Grenoble, CS 10217, 38043 Grenoble, France.
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, université de Bordeaux, Inserm U1045, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France.
authors.forename: F
authors.initials: F
authors.lastname: Laurent
authors.affiliation: Department of Thoracic Surgery, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Alifano
authors.affiliation: Histopathology and Cytology Laboratory, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mansuet-Lupo
authors.affiliation: Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: J N
authors.initials: JN
authors.lastname: Buy
authors.affiliation: Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Vadrot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D054363:Solitary Fibrous Tumor, Pleural / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Pleura; Pleural fibroma; Solitary fibrous tumor