Ultrasonography is superior to computed tomography and magnetic resonance imaging in determining superficial resection margins of malignant chest wall tumors.

The purpose of this study was to retrospectively analyze results obtained in 22 patients affected by malignant high-grade chest wall tumors evaluated preoperatively by ultrasonography as well as other imaging techniques. METHODS: Twenty-two patients with chest wall high-grade sarcomas routinely underwent computed tomography, magnetic resonance imaging, total body scintigraphy, and ultrasonography. Ultrasonography was always performed by the same person using an ultrasonography system with a 5- to 13-MHz probe and with color Doppler evaluation of the lesion. Scans were done with the patient positioned as during surgery. Tumor lateral margins were identified, and a line was marked at 4 cm. In 8 patients with local recurrence, the presence of micronodules was also studied. Results of computed tomography, magnetic resonance imaging, and ultrasonography were compared with the surgical specimens. RESULTS: Histologically, all surgical specimens excised according to ultrasonographic margins showed wide margins. Ultrasonography showed micronodules in 6 of 8 patients with local recurrence; histologically, they were all identified as sarcoma nodules. Ultrasonography failed in particular with cervical-mediastinal vessels. CONCLUSIONS: Our results confirm that ultrasonography is feasible and reliable in the study of superficial margins and for detection of micronodules of less than 0.5 cm in diameter.