S Hélage1, M P Revel2, M L Chabi1, É Audureau3, G Ferretti4, F Laurent5, M Alifano6, A Mansuet-Lupo7, J N Buy1, D Vadrot1. 1. Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France. 2. Department of Radiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France. Electronic address: marie-pierre.revel@aphp.fr. 3. Department of Biostatistics and Epidemiology, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France. 4. Department of Radiology, clinique universitaire de radiologie et imagerie médicale, CHU de Grenoble, CS 10217, 38043 Grenoble, France. 5. Department of Diagnostic and Therapeutic Radiology, université de Bordeaux, Inserm U1045, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France. 6. Department of Thoracic Surgery, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France. 7. Histopathology and Cytology Laboratory, hôpital Hôtel-Dieu (AP-HP), 1, place du Parvis-Notre-Dame, 75004 Paris, France.
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. PATIENTS AND 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. CONCLUSION: 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.
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. PATIENTS AND 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. CONCLUSION: 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: Mert Saynak; Nirmal K Veeramachaneni; Jessica L Hubbs; Dilruba Okumuş; Lawrence B Marks Journal: Balkan Med J Date: 2017-04-06 Impact factor: 2.021
Authors: Rachel M Mercer; Charlotte Wigston; Radhika Banka; Giuseppe Cardillo; Rachel Benamore; Andrew G Nicholson; Rachelle Asciak; Maged Hassan; Robert J Hallifax; Louise Wing; Eihab O Bedawi; Nick A Maskell; Elinor K Harriss; Robert F Miller; Najib M Rahman Journal: ERJ Open Res Date: 2020-08-17