Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
Eur J Radiol. 2022 Oct;155:110470. doi: 10.1016/j.ejrad.2022.110470. Epub 2022 Aug 10.
We aimed to analyze the diagnostic accuracy of preoperative CT-guided biopsy to identify patients that might profit from neoadjuvant chemotherapy in a specialized high-volume sarcoma center.
We retrospectively reviewed all patients with suspected soft tissue tumors of the abdomen cavity including the retroperitoneum, who received CT-guided biopsy followed by surgical tumor resection. Sensitivity, specificity, PPV and NPV were calculated in all patients with abdominal sarcomas at our hospital. A subgroup analysis was performed for patients with liposarcoma.
A total of 82 patients (35 female, 47 male, age: 62.0 ± 14.7) received preoperative CT-guided biopsy followed by surgical resection. Overall accordance of CT-guided biopsy to identify final histology was 77 %. CT-guided biopsy revealed the diagnosis of liposarcoma in 23 patients whereas final analysis of the surgical specimen identified liposarcoma in 29 patients. Here, sensitivity, specificity, PPV and NPV was 79.3 %, 100.0 %, 100.0 % and 89.8 % respectively. Subgroup analysis revealed a better accuracy for correctly identifying patients with well-differentiated liposarcoma than patients with dedifferentiated liposarcoma (75.0 % vs 62.5 %). In patients with other sarcoma, sensitivity, specificity, PPV, NPV and diagnostic accuracy was 87.5 %, 95.5 %, 82.4 % and 96.9 %, respectively.
CT-guided biopsy in a specialized high-volume sarcoma center is an accurate and effective method to assess patients with abdominal sarcoma and especially abdominal liposarcoma. Therefore, it is an indispensable tool in the pretherapeutic workup process. Nevertheless, our study underlines the previously reported difficulties in dedifferentiated liposarcoma diagnostics, whereby these patient cohort would profit the most from a neoadjuvant therapy regime.
我们旨在分析术前 CT 引导下活检在专门的大容量肉瘤中心识别可能从新辅助化疗中获益的患者的诊断准确性。
我们回顾性分析了所有在我院接受 CT 引导下活检后行手术肿瘤切除的疑似腹部（包括腹膜后腔）软组织肿瘤患者的资料。我们计算了所有在我院就诊的腹部肉瘤患者的敏感性、特异性、PPV 和 NPV。对脂肪肉瘤患者进行了亚组分析。
共有 82 例患者（女性 35 例，男性 47 例，年龄：62.0±14.7）接受了术前 CT 引导下活检后行手术切除。总体而言，CT 引导下活检与最终组织学的符合率为 77%。CT 引导下活检诊断为脂肪肉瘤的患者为 23 例，而手术标本的最终分析诊断为脂肪肉瘤的患者为 29 例。在此，敏感性、特异性、PPV 和 NPV 分别为 79.3%、100.0%、100.0%和 89.8%。亚组分析显示，正确识别高分化脂肪肉瘤患者的准确率高于去分化脂肪肉瘤患者（75.0%比 62.5%）。对于其他肉瘤患者，敏感性、特异性、PPV、NPV 和诊断准确性分别为 87.5%、95.5%、82.4%、96.9%。
在专门的大容量肉瘤中心进行 CT 引导下活检是评估腹部肉瘤患者，尤其是腹部脂肪肉瘤患者的一种准确、有效的方法。因此，它是治疗前评估过程中不可或缺的工具。然而，我们的研究强调了去分化脂肪肉瘤诊断中先前报道的困难，这些患者群体最有可能从新辅助治疗方案中获益。
