Longo Maurizio, Zani Davide Danilo, Ferrari Roberta, Bassi Jessica, Andreis Maria Elena, Stefanello Damiano, Giudice Chiara, Grieco Valeria, Liuti Tiziana, Handel Ian, Di Giancamillo Mauro
1 Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, UK.
2 Department of Veterinary Medicine, University of Milan, Milan, Italy.
J Feline Med Surg. 2018 Jun;20(6):502-508. doi: 10.1177/1098612X17717176. Epub 2017 Jun 30.
Objectives Feline injection-site sarcomas (FISSs) are soft tissue tumours typically characterised by an interscapular location and highly infiltrative behaviour. CT is considered the modality of choice for FISS staging and double positioning (dynamic approach) was reported to successfully detect the exact extent of infiltration into the muscles. The aim of the present study was to investigate the utility of the dynamic approach in feline patients referred for preoperative staging of interscapular FISS. Methods Tumour volume estimates were compared between the ellipsoid and the semi-automated segmentation methods. Two radiologists blinded to the patient coding used images from each position to assess the extent of muscular infiltration. The distance between the neoplasm and the adjacent skeletal structures (scapulae, spinous processes) was recorded in both positions by a single radiologist. Results Fifty-nine of 84 neoplasms invaded the adjacent muscular structures, with up to 15 muscles infiltrated. Between the extended and flexed position the average estimated numbers of muscles infiltrated were 1.9 (extended) and 1.84 (flexed) for observer A and 1.89 (extended) and 1.85 (flexed) for observer B. Good agreement between observers was established, with higher tumour volumes detected via the ellipsoid method. Moreover, tumours with smaller volumes showed slightly decreased muscular infiltration. Marked difference in the recorded distance between the skeletal structures and the neoplasm in the two different positions was established (mean ± SD difference spinous processes: 9.74 ± 9.57 mm; mean ± SD difference scapulae: 15.15 ± 11.76 mm). Conclusions and relevance A dynamic approach should be used for a complete evaluation of the invasiveness of FISS along with appropriate methodology for tumour volume measurement, which could potentially alter the tomographic estimation of the real dimension of the neoplasms.
目的 猫注射部位肉瘤（FISS）是软组织肿瘤，其典型特征是位于肩胛间且具有高度浸润性。CT被认为是FISS分期的首选检查方式，据报道，双定位（动态方法）能成功检测出肿瘤向肌肉浸润的确切范围。本研究的目的是探讨动态方法在转诊进行肩胛间FISS术前分期的猫科动物患者中的应用价值。方法 比较了椭球体法和半自动分割法对肿瘤体积的估计。两名对患者编码不知情的放射科医生使用每个位置的图像评估肌肉浸润范围。由一名放射科医生在两个位置记录肿瘤与相邻骨骼结构（肩胛骨、棘突）之间的距离。结果 84个肿瘤中有59个侵犯了相邻的肌肉结构，最多累及15块肌肉。在伸展位和屈曲位之间，观察者A估计的平均浸润肌肉数量分别为1.9（伸展位）和1.84（屈曲位），观察者B为1.89（伸展位）和1.85（屈曲位）。观察者之间一致性良好，通过椭球体法检测到的肿瘤体积更大。此外，体积较小的肿瘤肌肉浸润略有减少。两个不同位置的骨骼结构与肿瘤之间记录的距离存在显著差异（棘突平均±标准差差异：9.74±9.57mm；肩胛骨平均±标准差差异：15.15±11.76mm）。结论及相关性 应采用动态方法并结合适当的肿瘤体积测量方法来全面评估FISS的侵袭性，这可能会改变肿瘤实际大小的断层扫描估计。
