Soft tissue tumors of the hand and digits - The role of preoperative ultrasound compared to MRI
Tina Deutinger, Hannes Gruber, Turkhan Mehdiyev, Leonhard Gruber, Yannick Scharll, Caroline Bauer, Robert ZimmermannIntroduction
Soft tissue tumors of the hand and digits are often small and clinically non-specific, leading surgeons to omit preoperative imaging. Magnetic resonance imaging is traditionally considered the reference standard for soft tissue tumors, but its role in the evaluation of small lesions in this anatomic region is not well defined. Ultrasound, as a readily available and cost-effective modality for superficial lesions, offers potential advantages. This study evaluates the diagnostic accuracy of preoperative ultrasound in soft tissue tumors of the hand and digits.
Materials and methods
A retrospective analysis was performed on patients who underwent surgical excision of soft tissue tumors of the hand in a tertiary referral center between January 1st, 2013, and December 31st, 2020. Demographic data, preoperative imaging reports, and histopathological diagnoses were collected. Histopathology served as the reference standard. Imaging data were re-analyzed per-modality by one radiologist blinded to the final diagnosis. Sensitivity, specificity, and overall accuracy of ultrasound and magnetic resonance imaging were calculated.
Results
A total of 194 patients were included. Most lesions were benign (91%, 177/194), whereas 8% (15/194) were intermediate and 1% (2/194) malignant. Predictors of intermediate/malignant histology included larger tumor size (
Conclusion
Ultrasound is an indispensable tool in the preoperative work-up of soft tissue tumors of the hand and digits. Given its sensitivity and overall accuracy, it should be considered the primary initial imaging modality, with magnetic resonance imaging reserved for cases with suspicious findings.