Federica Ciccarese1, Alberto Bazzocchi2, Rosanna Ciminari2, Alberto Righi3, Michele Rocca4, Eugenio Rimondi2, Piero Picci3, Maria L Bacchi Reggiani5, Ugo Albisinni2, Maurizio Zompatori6, Daniel Vanel2. 1. Radiology Unit, Cardio-Thoracic-Vascular Department, S. Orsola Malpighi University Hospital, via Masserenti 9, 40100 Bologna, Italy. Electronic address: ciccarese.f@gmail.com. 2. Diagnostic and Interventional Radiology, The Rizzoli Institute, via Pupilli 1, 40110 Bologna, Italy. 3. Department of Pathology, The Rizzoli Institute, via Pupilli 1, 40110 Bologna, Italy. 4. Unit of General Surgery, The Rizzoli Institute, via Pupilli 1, 40110 Bologna, Italy. 5. Cardiology Institute, Cardio-Thoracic-Vascular Department, S.Orsola Malpighi University Hospital, via Masserenti 9, 40100 Bologna, Italy. 6. Radiology Unit, Cardio-Thoracic-Vascular Department, S. Orsola Malpighi University Hospital, via Masserenti 9, 40100 Bologna, Italy.
Abstract
OBJECTIVE: CT is the recommended technique for the detection of pulmonary metastases in patients affected by osteosarcoma, though claimed to show several limits compared to manual palpation. We retrospectively analyzed CT features of suspected lesions submitted to surgery to address its current accuracy and to investigate criteria for predicting histology. MATERIALS AND METHODS: CT scans of 70 patients submitted to thoracotomy between 2007-2013 were reviewed. Overall, 123 thoracotomies were performed and 283 lesions seen on CT were resected. Shape, size, presence and type of calcification, evolution of each lesion were analyzed. Number and histology of nodules detected at thoracotomy were recorded and compared to CT data. RESULTS: 234/283--82.7% Lesions were metastases; 143--61.1% were calcified; most metastases were nodular (201/234--85.9%), but in 33/234--14.1% other findings were detected (striae, consolidations, pleural plaques/masses, cavitations, ground glass opacities, irregular shapes, halo sign). Malignant lesions were more frequently calcified, larger, with progression over time--p<0.0001. Manual palpation identified 314 lesions, 248 metastatic--79.0%: CT missed 31/314--9.9% lesions, whereof 14/31--45.2% were metastases. CONCLUSIONS: Though most lesions are nodular and calcified, up to 40% are not calcified and atypical findings are not uncommon (14.1%). The identification of the atypical radiological presentation of metastases could be the key for improving CT accuracy.
OBJECTIVE: CT is the recommended technique for the detection of pulmonary metastases in patients affected by osteosarcoma, though claimed to show several limits compared to manual palpation. We retrospectively analyzed CT features of suspected lesions submitted to surgery to address its current accuracy and to investigate criteria for predicting histology. MATERIALS AND METHODS: CT scans of 70 patients submitted to thoracotomy between 2007-2013 were reviewed. Overall, 123 thoracotomies were performed and 283 lesions seen on CT were resected. Shape, size, presence and type of calcification, evolution of each lesion were analyzed. Number and histology of nodules detected at thoracotomy were recorded and compared to CT data. RESULTS: 234/283--82.7% Lesions were metastases; 143--61.1% were calcified; most metastases were nodular (201/234--85.9%), but in 33/234--14.1% other findings were detected (striae, consolidations, pleural plaques/masses, cavitations, ground glass opacities, irregular shapes, halo sign). Malignant lesions were more frequently calcified, larger, with progression over time--p<0.0001. Manual palpation identified 314 lesions, 248 metastatic--79.0%: CT missed 31/314--9.9% lesions, whereof 14/31--45.2% were metastases. CONCLUSIONS: Though most lesions are nodular and calcified, up to 40% are not calcified and atypical findings are not uncommon (14.1%). The identification of the atypical radiological presentation of metastases could be the key for improving CT accuracy.
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
Authors: Kim M Tsoi; Martin Lowe; Yusuke Tsuda; Johnathan R Lex; Tomohiro Fujiwara; Ghassan Almeer; Jonathan Gregory; Jonathan Stevenson; Scott E Evans; Rajesh Botchu; Lee M Jeys Journal: Clin Orthop Relat Res Date: 2021-02-01 Impact factor: 4.755