Extra-hepatic sarcoma metastasis surveillance in the liver: is arterial phase imaging necessary?

Peter A. Harri, Alex Chung, Srini Tridandapani, Sadhna Nandwana, Oluwayemisi O. Ibraheem, Kelly Cox, Fredrick Murphy, Pardeep Kumar Mittal, William Small

Research output: Contribution to journalArticle

Abstract

Purpose: To assess the value of arterial phase imaging (ART) in the detection of liver metastases on CT compared to portal venous phase imaging (PV) alone in patients with primary sarcomas. Methods: Multiphasic abdominal computed tomography (CT) images of patients with tissue-proven sarcomas were reviewed by five abdominal radiologists in a staggered fashion. Up to three of the largest or most conspicuous liver lesions were characterized on a four-point confidence level for PV independently, followed by PV + ART. Inter-observer reliability was evaluated with kappa statistics. Change in characterization of lesions by the addition of ART was calculated. Follow-up imaging was used to determine if index lesion characterization was valid. Results: 55 of 149 patients had 470 liver lesion characterizations by the five readers with follow-up. Inter-observer agreement was κ = 0.62 on PV and κ = 0.58 on PV + ART. The intra-observer agreement between PV and ART interpretations of the same lesion was κ = 0.93. 426 lesion characterizations were possible on both PV and ART. Only 6 characterizations were changed after the addition of ART; 4 of the 6 changes were incorrect when compared to follow-up. Only 6 lesion characterizations could be made on ART alone (missed by PV), with all the malignant lesions arising from primary leiomyosarcomas. For the lesions seen on PV alone, the sensitivity, specificity, PPV, NPV, and accuracy were 98.8%, 100%, 100%, 99.3%, and 99.6%, respectively. After the addition of ART, they were 98.8%, 98.7%, 97.5%, 99.4%, and 98.7%, respectively. Conclusion: ART adds marginal value to PV for characterization of metastatic liver lesions in patients with primary sarcomas, except possibly in primary leiomyosarcomas.

Original languageEnglish (US)
Pages (from-to)1679-1684
Number of pages6
JournalAbdominal Radiology
Volume42
Issue number6
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

Fingerprint

Sarcoma
Neoplasm Metastasis
Leiomyosarcoma
Liver
Tomography
Sensitivity and Specificity

Keywords

  • Computed tomography
  • Liver metastases
  • Sarcoma
  • Surveillance

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Harri, P. A., Chung, A., Tridandapani, S., Nandwana, S., Ibraheem, O. O., Cox, K., ... Small, W. (2017). Extra-hepatic sarcoma metastasis surveillance in the liver: is arterial phase imaging necessary? Abdominal Radiology, 42(6), 1679-1684. https://doi.org/10.1007/s00261-017-1060-4

Extra-hepatic sarcoma metastasis surveillance in the liver : is arterial phase imaging necessary? / Harri, Peter A.; Chung, Alex; Tridandapani, Srini; Nandwana, Sadhna; Ibraheem, Oluwayemisi O.; Cox, Kelly; Murphy, Fredrick; Mittal, Pardeep Kumar; Small, William.

In: Abdominal Radiology, Vol. 42, No. 6, 01.06.2017, p. 1679-1684.

Research output: Contribution to journalArticle

Harri, PA, Chung, A, Tridandapani, S, Nandwana, S, Ibraheem, OO, Cox, K, Murphy, F, Mittal, PK & Small, W 2017, 'Extra-hepatic sarcoma metastasis surveillance in the liver: is arterial phase imaging necessary?', Abdominal Radiology, vol. 42, no. 6, pp. 1679-1684. https://doi.org/10.1007/s00261-017-1060-4
Harri PA, Chung A, Tridandapani S, Nandwana S, Ibraheem OO, Cox K et al. Extra-hepatic sarcoma metastasis surveillance in the liver: is arterial phase imaging necessary? Abdominal Radiology. 2017 Jun 1;42(6):1679-1684. https://doi.org/10.1007/s00261-017-1060-4
Harri, Peter A. ; Chung, Alex ; Tridandapani, Srini ; Nandwana, Sadhna ; Ibraheem, Oluwayemisi O. ; Cox, Kelly ; Murphy, Fredrick ; Mittal, Pardeep Kumar ; Small, William. / Extra-hepatic sarcoma metastasis surveillance in the liver : is arterial phase imaging necessary?. In: Abdominal Radiology. 2017 ; Vol. 42, No. 6. pp. 1679-1684.
@article{d919c5fb2507407c8925d7981dd1ab7d,
title = "Extra-hepatic sarcoma metastasis surveillance in the liver: is arterial phase imaging necessary?",
abstract = "Purpose: To assess the value of arterial phase imaging (ART) in the detection of liver metastases on CT compared to portal venous phase imaging (PV) alone in patients with primary sarcomas. Methods: Multiphasic abdominal computed tomography (CT) images of patients with tissue-proven sarcomas were reviewed by five abdominal radiologists in a staggered fashion. Up to three of the largest or most conspicuous liver lesions were characterized on a four-point confidence level for PV independently, followed by PV + ART. Inter-observer reliability was evaluated with kappa statistics. Change in characterization of lesions by the addition of ART was calculated. Follow-up imaging was used to determine if index lesion characterization was valid. Results: 55 of 149 patients had 470 liver lesion characterizations by the five readers with follow-up. Inter-observer agreement was κ = 0.62 on PV and κ = 0.58 on PV + ART. The intra-observer agreement between PV and ART interpretations of the same lesion was κ = 0.93. 426 lesion characterizations were possible on both PV and ART. Only 6 characterizations were changed after the addition of ART; 4 of the 6 changes were incorrect when compared to follow-up. Only 6 lesion characterizations could be made on ART alone (missed by PV), with all the malignant lesions arising from primary leiomyosarcomas. For the lesions seen on PV alone, the sensitivity, specificity, PPV, NPV, and accuracy were 98.8{\%}, 100{\%}, 100{\%}, 99.3{\%}, and 99.6{\%}, respectively. After the addition of ART, they were 98.8{\%}, 98.7{\%}, 97.5{\%}, 99.4{\%}, and 98.7{\%}, respectively. Conclusion: ART adds marginal value to PV for characterization of metastatic liver lesions in patients with primary sarcomas, except possibly in primary leiomyosarcomas.",
keywords = "Computed tomography, Liver metastases, Sarcoma, Surveillance",
author = "Harri, {Peter A.} and Alex Chung and Srini Tridandapani and Sadhna Nandwana and Ibraheem, {Oluwayemisi O.} and Kelly Cox and Fredrick Murphy and Mittal, {Pardeep Kumar} and William Small",
year = "2017",
month = "6",
day = "1",
doi = "10.1007/s00261-017-1060-4",
language = "English (US)",
volume = "42",
pages = "1679--1684",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Extra-hepatic sarcoma metastasis surveillance in the liver

T2 - is arterial phase imaging necessary?

AU - Harri, Peter A.

AU - Chung, Alex

AU - Tridandapani, Srini

AU - Nandwana, Sadhna

AU - Ibraheem, Oluwayemisi O.

AU - Cox, Kelly

AU - Murphy, Fredrick

AU - Mittal, Pardeep Kumar

AU - Small, William

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Purpose: To assess the value of arterial phase imaging (ART) in the detection of liver metastases on CT compared to portal venous phase imaging (PV) alone in patients with primary sarcomas. Methods: Multiphasic abdominal computed tomography (CT) images of patients with tissue-proven sarcomas were reviewed by five abdominal radiologists in a staggered fashion. Up to three of the largest or most conspicuous liver lesions were characterized on a four-point confidence level for PV independently, followed by PV + ART. Inter-observer reliability was evaluated with kappa statistics. Change in characterization of lesions by the addition of ART was calculated. Follow-up imaging was used to determine if index lesion characterization was valid. Results: 55 of 149 patients had 470 liver lesion characterizations by the five readers with follow-up. Inter-observer agreement was κ = 0.62 on PV and κ = 0.58 on PV + ART. The intra-observer agreement between PV and ART interpretations of the same lesion was κ = 0.93. 426 lesion characterizations were possible on both PV and ART. Only 6 characterizations were changed after the addition of ART; 4 of the 6 changes were incorrect when compared to follow-up. Only 6 lesion characterizations could be made on ART alone (missed by PV), with all the malignant lesions arising from primary leiomyosarcomas. For the lesions seen on PV alone, the sensitivity, specificity, PPV, NPV, and accuracy were 98.8%, 100%, 100%, 99.3%, and 99.6%, respectively. After the addition of ART, they were 98.8%, 98.7%, 97.5%, 99.4%, and 98.7%, respectively. Conclusion: ART adds marginal value to PV for characterization of metastatic liver lesions in patients with primary sarcomas, except possibly in primary leiomyosarcomas.

AB - Purpose: To assess the value of arterial phase imaging (ART) in the detection of liver metastases on CT compared to portal venous phase imaging (PV) alone in patients with primary sarcomas. Methods: Multiphasic abdominal computed tomography (CT) images of patients with tissue-proven sarcomas were reviewed by five abdominal radiologists in a staggered fashion. Up to three of the largest or most conspicuous liver lesions were characterized on a four-point confidence level for PV independently, followed by PV + ART. Inter-observer reliability was evaluated with kappa statistics. Change in characterization of lesions by the addition of ART was calculated. Follow-up imaging was used to determine if index lesion characterization was valid. Results: 55 of 149 patients had 470 liver lesion characterizations by the five readers with follow-up. Inter-observer agreement was κ = 0.62 on PV and κ = 0.58 on PV + ART. The intra-observer agreement between PV and ART interpretations of the same lesion was κ = 0.93. 426 lesion characterizations were possible on both PV and ART. Only 6 characterizations were changed after the addition of ART; 4 of the 6 changes were incorrect when compared to follow-up. Only 6 lesion characterizations could be made on ART alone (missed by PV), with all the malignant lesions arising from primary leiomyosarcomas. For the lesions seen on PV alone, the sensitivity, specificity, PPV, NPV, and accuracy were 98.8%, 100%, 100%, 99.3%, and 99.6%, respectively. After the addition of ART, they were 98.8%, 98.7%, 97.5%, 99.4%, and 98.7%, respectively. Conclusion: ART adds marginal value to PV for characterization of metastatic liver lesions in patients with primary sarcomas, except possibly in primary leiomyosarcomas.

KW - Computed tomography

KW - Liver metastases

KW - Sarcoma

KW - Surveillance

UR - http://www.scopus.com/inward/record.url?scp=85011672640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011672640&partnerID=8YFLogxK

U2 - 10.1007/s00261-017-1060-4

DO - 10.1007/s00261-017-1060-4

M3 - Article

C2 - 28154907

AN - SCOPUS:85011672640

VL - 42

SP - 1679

EP - 1684

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

IS - 6

ER -