Ultrasound accurate, cost-effective for assessing soft-tissue masses referred by primary care providers
Ultrasound is an effective screening tool for assessing soft-tissue masses referred by primary care providers, according to a new study published in Clinical Radiology. The authors added that a “vast majority” of these masses are benign.
Researchers from the department of radiology at Sheffield Teaching Hospital in the U.K. performed a retrospective analysis on patients who presented with a suspected soft-tissue mass and underwent ultrasound at a single facility ion 2011 and 2012. Overall, the diagnosis was benign in 95 percent of patients. Ninety-one percent of the time, no additional imaging or histopathology assessment was required. Just 0.7 percent of patients had a proven malignant lesion.
For 6 percent of patients, there was a follow-up histological assessment. In those cases, the sensitivity of ultrasound was 94 percent, specificity was 71 percent and accuracy was 73 percent.
In addition, ultrasound had a positive predictive value for diagnosing malignancy of 19 percent and a negative predictive value for excluding malignancy of 99.95 percent.
“The high negative predictive value of ultrasound in this study highlights how effectively it can be used to provide a reassuring diagnosis that requires no further investigation and no future anxiety for the patient, which is of huge value,” wrote co-author Nikhl Kotnis, MbChB, and colleagues. “The present results also confirm that MRI should generally be used only following an indeterminate or suspicious ultrasound examination, and is usually best organized after consultation with a consultant radiologist or specialist sarcoma service.”
The authors also noted that MRI is the best next step for follow-up imaging of intermediate findings, but going to ultrasound first for these patients does result in significant cost savings.
Also, though malignant lesions were rare in these patients, Kotnis et al. emphasized that proper supervision is still necessary.
“The importance of adequate supervision of such a screening service by experienced radiologists is stressed, as otherwise there is still a risk of inappropriate referrals to sarcoma centers,” the authors wrote.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.