Cargando…

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

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) wa...

Descripción completa

Detalles Bibliográficos
Autores principales: De Marchi, Armanda, Pozza, Simona, Charrier, Lorena, Cannone, Filadelfo, Cavallo, Franco, Linari, Alessandra, Piana, Raimondo, Geniò, Irene, Balocco, Paolo, Massè, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730454/
https://www.ncbi.nlm.nih.gov/pubmed/33260631
http://dx.doi.org/10.3390/ijerph17238868
_version_ 1783621688010735616
author De Marchi, Armanda
Pozza, Simona
Charrier, Lorena
Cannone, Filadelfo
Cavallo, Franco
Linari, Alessandra
Piana, Raimondo
Geniò, Irene
Balocco, Paolo
Massè, Alessandro
author_facet De Marchi, Armanda
Pozza, Simona
Charrier, Lorena
Cannone, Filadelfo
Cavallo, Franco
Linari, Alessandra
Piana, Raimondo
Geniò, Irene
Balocco, Paolo
Massè, Alessandro
author_sort De Marchi, Armanda
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7730454
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-77304542020-12-12 Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses De Marchi, Armanda Pozza, Simona Charrier, Lorena Cannone, Filadelfo Cavallo, Franco Linari, Alessandra Piana, Raimondo Geniò, Irene Balocco, Paolo Massè, Alessandro Int J Environ Res Public Health Article 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. MDPI 2020-11-28 2020-12 /pmc/articles/PMC7730454/ /pubmed/33260631 http://dx.doi.org/10.3390/ijerph17238868 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Marchi, Armanda
Pozza, Simona
Charrier, Lorena
Cannone, Filadelfo
Cavallo, Franco
Linari, Alessandra
Piana, Raimondo
Geniò, Irene
Balocco, Paolo
Massè, Alessandro
Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title_full Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title_fullStr Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title_full_unstemmed Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title_short Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses
title_sort small subcutaneous soft tissue tumors (<5 cm) can be sarcomas and contrast-enhanced ultrasound (ceus) is useful to identify potentially malignant masses
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730454/
https://www.ncbi.nlm.nih.gov/pubmed/33260631
http://dx.doi.org/10.3390/ijerph17238868
work_keys_str_mv AT demarchiarmanda smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT pozzasimona smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT charrierlorena smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT cannonefiladelfo smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT cavallofranco smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT linarialessandra smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT pianaraimondo smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT genioirene smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT baloccopaolo smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses
AT massealessandro smallsubcutaneoussofttissuetumors5cmcanbesarcomasandcontrastenhancedultrasoundceusisusefultoidentifypotentiallymalignantmasses