Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses

Armanda De Marchi, Simona Pozza, Lorena Charrier, Filadelfo Cannone, Franco Cavallo, Alessandra Linari, Raimondo Piana, Irene Geniò, Paolo Balocco and Alessandro Massè
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Armanda De Marchi: Department of Imaging, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy
Simona Pozza: Department of Imaging, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy
Lorena Charrier: Department of Public Health and Pediatrics, University of Turin, Via Santena 5-bis, 10126 Torino, Italy
Filadelfo Cannone: Radiology Department, Azienda Sanitaria Provinciale di Siracusa, E. Muscatello Hospital, Contrada Granatello, 96011 Augusta, Italy
Franco Cavallo: Department of Public Health and Pediatrics, University of Turin, Via Santena 5-bis, 10126 Torino, Italy
Alessandra Linari: Department of Pathology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy
Raimondo Piana: Department of Orthopaedic, Traumatology and Rehabilitation, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy
Irene Geniò: Department of Imaging, Azienda Ospedaliero Universitaria G. Martino, Via Consolare Valeria 1, 98100 Messina, Italy
Paolo Balocco: Department of Imaging, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy
Alessandro Massè: Department of Orthopaedic, Traumatology and Rehabilitation, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino, Italy

IJERPH, 2020, vol. 17, issue 23, 1-12

Abstract: Subcutaneous masses smaller than 5 cm can be malignant, in contrast with the international guidelines. Ultrasound (US) and magnetic resonance imaging (MRI) are useful to distinguish a potentially malignant mass from the numerous benign soft tissue (ST) lesions. Contrast-enhanced ultrasound (CEUS) was applied in ST tumors, without distinguishing the subcutaneous from the deep lesions. We evaluated CEUS and MRI accuracy in comparison to histology in differentiating malignant from nonmalignant superficial ST masses, 50% smaller than 5 cm. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) with their 95% confidence intervals (CI) were calculated. Of malignant cases, 44.4% measured ≤5 cm. At univariate analysis, no statistically significant differences emerged between benign and malignant tumors in relation with clinical characteristics, except for relationship with the deep fascia ( p = 0.048). MRI accuracy: sensitivity 52.8% (CI 37.0, 68.0), specificity 74.1% (CI 55.3, 86.8), PPV 73.1% (CI 53.9, 86.3), and NPV 54.1% (CI 38.4, 69.0). CEUS accuracy: sensitivity 75% (CI 58.9, 86.3), specificity 37% (CI 21.5, 55.8), PPV 61.4% (CI 46.6, 74.3), and NPV 52.6% (CI 31.7, 72.7). CEUS showed a sensitivity higher than MRI, whereas PPV and NPV were comparable. Also, masses measuring less than 5 cm can be malignant and referral criteria for centralization could be revised.

Keywords: contrast media; ultrasonography; magnetic resonance imaging; soft tissue neoplasms; standards (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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