Soft Tissue Sarcomas: Experience of a Radiologist-led Diagnostic Satellite Sarcoma Center with Analysis of 3 Years of US-guided Core Biopsy Data

Purpose or Learning Objective: The aim of this retrospective study was to analyze ultrasonography (US)-guided core biopsy data to determine the proportion of biopsy-positive sarcomas in our patient population and to review the spectrum of alternative diagnoses encountered. We also demonstrate the relevant patient pathways in a radiologist-led satellite diagnostics sarcoma center for the safe and effective initial management of patients referred from primary care or secondary services with suspected sarcoma.

Methods or Background: A retrospective analysis of all consecutive patients undergoing US-guided core biopsy under the suspected sarcoma pathway between January 2019 and January 2022 was conducted. The patient population was identified from data input into the Somerset cancer database following the local weekly soft tissue and sarcoma multidisciplinary team meeting where all suspected sarcoma patients are discussed. Histopathology data were retrieved from the ICE system and radiology data from the picture archiving and communication system (PACS).

Results or Findings: Data from 267 patients were collected. A diagnosis or provisional diagnosis was made on the first core biopsy of 261 tissue patients (97.8%). The most common site for lesions was the lower extremity (134 [50.1%]). A total of 185 (69.3%) lesions were identified as benign and 76 (28.5%) as malignant. Of the malignant lesions, 36 (13.5% of the patient cohort) were identified as sarcomas. Of the many benign lesions, the most commonly biopsies were benign cutaneous lesions (37 [13.9%]), benign fibrous lesions (21 [7.9%]), and benign neural tumors (19 [7.12%]). There was a 0% complication rate.

Conclusion: We demonstrate the operational efficiency of our satellite diagnostic sarcoma center in the safe and effective initial management of suspected sarcomas, reducing waiting times and burden on a specialist sarcoma center. Within our patient cohort of 267 patients, in a 3-year period, 36 patients were identified as having a sarcoma determined by core biopsy and referred for immediate management at the tertiary sarcoma specialist center. We also describe the variation of tissue-proven soft tissue lesions encountered under the sarcoma referral pathway.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
02 June 2022