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Objectives: Soft tissue tumours (STT) require accurate diagnosis in order to identify potential malignancies. Preoperative planning is fundamental to avoid inadequate treatments. The role of contrast-enhanced computed tomography (CT) for local staging remains incompletely assessed. Aims of the study were to evaluate CT accuracy in discriminating active from aggressive tumours compared to histology and evaluate the role of CT angiography (CTA) in surgical planning., Materials and Methods: This retrospective cohort series of 88 cases from 1200 patients (7 %) was locally studied by contrast-enhanced CT and CTA in a referral centre: 74 malignant tumours, 14 benign lesions. Contrast-enhancement patterns and relationship of the mass with major vessels and bone were compared with histology on surgically excised samples. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were evaluated in discriminating active from aggressive tumours., Results: Sensitivity in differentiating aggressive tumours from active lesions was 89 %, specificity 84 %, PPV 90 %, NPV 82 %. The relationship between mass and major vessels/bone was fundamental for surgical strategy respectively in 40 % and in 58 % of malignant tumours., Conclusion: Contrast-enhanced CT and CTA are effective in differentiating aggressive masses from active lesions in soft tissue and in depicting the relationship between tumour and adjacent bones and major vessels., Key Points: • Accurate delineation of vascular and bony involvement preoperatively is fundamental for a correct resection. • CT plays a critical role in differential diagnosis of soft tissue masses. • Contrast-enhanced CT and CT angiography are helpful in depicting tumoral vascular involvement. • CT is optimal for characterization of bone involvement in soft tissue malignancies.

Purpose: To review the role of Computed Tomography (CT) in thoracic complications following orthotopic liver transplantation (OLT)., Material and Methods: In a post-OLT population of 567 patients transplanted in our institution, 100 patients (17.6%) were examined with chest CT. We reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique--i.e., conventional (with(out) intravenous, i.v., contrast material) or high-resolution (HRCT). We also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results., Results: Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in 12 cases (7.9%) the reasons were unknown; 133/152 (87.5%) examinations had been performed with conventional CT scanning (100 with i.v. contrast agent and 33 without) and 19/152 (12.5%) with HRCT. Twenty of 152 (13.2%) examinations, in 16 patients, were normal; in the other 84 patients, 132/152 (86.8%) CT/HRCT studies showed 247 pathological findings (99 pleural effusions, 3 pericardial effusions, 62 cases of atelectasis, 1 pulmonary calcification, 70 suspected inflammatory parenchymal consolidations, 64 of them alveolar and 6 interstitial, 4 cases of interstitial edema and finally 8 neoplastic infiltrates)., Discussion: Correlated with clinical data, CT findings are very useful in detailing clinical-radiographic screening findings, despite the limitations in typifying pleural effusions, in differentiating atelectases from inflammatory parenchymal consolidations and in assessing pneumonia etiology. Also, despite its high sensitivity (94.1%) and specificity (92.8%), CT was not accurate enough in the differential diagnosis of pneumonia. History data were necessary to characterize the histology of neoplastic infiltrates., Conclusions: Chest CT has relatively uncommon, and sometimes only clinical, indications in post-OLT patients. The technique is chosen based on clinical-radiographic findings. CT proved useful in showing negative cases and in detailing clinical and radiographic findings but must be integrated with clinical findings to define inflammatory and neoplastic conditions.