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Diagnostic concordance between ultrasound-guided core needle biopsy and surgical resection specimens for histological grading of extremity and trunk soft tissue sarcoma

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Abstract

Objective

Determination of accurate histological grade impacts on management for soft tissue sarcomas (STSs). Although ultrasound-guided core needle biopsy (US-CNB) accurately establishes tumour subtype compared with surgical specimens, the concordance for tumour grade is uncertain. The aim of this study was to assess the concordance between US-CNB and surgical resection specimens for tumour grade in trunk and extremity STS.

Materials and methods

Retrospective review of consecutive patients presenting with extremity/trunk STS. Data collected included patient age, gender, lesion location, US-CNB diagnosis and grade, and surgical histology and grade. The histological diagnosis and tumour grade from US-CNB was compared with surgical resection histology.

Results

A total of 118 patients were included, 76 males and 42 females with a mean age of 54 years (range 10 months–90 years old). STS size ranged from 26 to 350 mm (mean 89.5 mm). All US-CNB procedures were performed with a 14G biopsy needle with a mean number of 5 passes. First US-CNB was diagnostic for STS in all patients, and provided adequate tissue for tumour grading in all but one patient. Histological tumour subtype on US-CNB matched surgical specimens in all cases, with 25 (21.2%) STS being low grade and 93 (78.8%) high grade. The concordance for tumour grade was 96.6%, with no difference between low- and high-grade STSs (p > 0.05). The 4 cases of mismatch were considered low grade on US-CNB, but subsequently high grade on surgical resection.

Conclusion

US-CNB of STS can reliably predict histological tumour grade compared with surgical resection specimens, thus allowing confident treatment decisions to be made.

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Authors and Affiliations

  1. Department of Radiology, Mid and South Essex University Hospitals Group, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK

    A. Tan

  2. Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, London, HA7 4LP, UK

    R. Rajakulasingam & A. Saifuddin

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  1. A. Tan
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  2. R. Rajakulasingam
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  3. A. Saifuddin
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Correspondence to R. Rajakulasingam.

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Tan, A., Rajakulasingam, R. & Saifuddin, A. Diagnostic concordance between ultrasound-guided core needle biopsy and surgical resection specimens for histological grading of extremity and trunk soft tissue sarcoma. Skeletal Radiol 50, 43–50 (2021). https://doi.org/10.1007/s00256-020-03496-8

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  • DOI: https://doi.org/10.1007/s00256-020-03496-8

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