The role of computed tomography in the management of soft tissue sarcomas

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Abstract
Patients (77) with soft tissue sarcoma underwent computed tomography (CT) between 1977 and 1981. The majority of tumors appeared as masses which were well-defined, either by surrounding soft tissue planes or because the tumor had a significantly different attenuation value to the surrounding tissues. No correlation was found between the characteristics on CT and the tumor histology. A prediction of operability based on the CT appearances was correct in 22 patients (92%) and further useful surgical information was provided in 11 patients (46%). A comparison of the CT findings with those of chest radiography, including whole lung tomography, showed that CT demonstrated a significantly larger number of pulmonary metastases. CT was also useful in revealing unsuspected local recurrences in 4 of 18 patients although 1 false positive diagnosis was made. Overall, the information provided by CT altered the clinical management in 18 patients (23%); the most important change was that surgery was avoided. CT should be regarded as the investigation of choice for the assessment of the primary or locally recurrent tumor and the detection of occult pulmonary metastases.