Soft tissue sarcomas: Ultrasonographic evaluation of local recurrences

OBJECTIVE: The diagnosis of early local recurrence of soft tissue sarcomas, especially in those treated with surgery and radiotherapy, is a difficult clinical problem, Financial constraints led us to use ultrasonography inste ad of CT or MR imaging. The aim of this study was to evaluate the role of u ltrasonography (US) in detecting local recurrence. METHODS AND RESULTS: Fifty patients with previous treatment for soft tissue sarcomas were evaluated prospectively for recurrence by US and histopathol ogy. Seven of the 50 patients were clinically suspected to have recurrent t umour. Ultrasonography showed recurrence in 26, no recurrence in 18, benign disease in four and was indeterminate in two cases. Ultrasonography was in strumental in guiding fine needle aspiration biopsies of small local recurr ences and indeterminate lesions in 17 patients. In the sonographically tumo ur positive patients, histopathology confirmed recurrence in 24; one case h ad benign disease and one patient refused surgery. Thirteen of the 18 sonog raphically tumour negative patients were operated upon; all were negative f or tumour on histopathology, Both the indeterminate cases showed recurrence on histopathology, The benign cases were confirmed by histopathology corre lation. Ultrasound guided fine needle aspiration cytology (FNAC) was positi ve in 14 out of 17 patients (88%), The sensitivity and specificity of US wa s 92.30% and 94.4% respectively. CONCLUSION: Our study concludes that US is an extremely useful and cost eff ective method in the detection of early local recurrences of soft tissue sa rcomas and should therefore be used for initial routine follow-up and guide d biopsies. (C) 2000 The Royal College of Radiologists.