{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:23:33Z","timestamp":1776090213779,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Since 2015, the American College of Radiology (ACR) has recommended staging for lung metastasis via chest computed tomography\u00a0(CT) without contrast for extremity sarcoma staging and surveillance. The purpose of this study was to determine our institutional compliance with this recommendation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective chart review of patients diagnosed with sarcoma in the extremities who received CT imaging of the chest for pulmonary staging and surveillance at our institution from 2005 to 2023. A total of 1916 CT studies were included for analysis. We scrutinized ordering patterns before and after 2015 based on the ACR\u2010published\u00a0metastasis staging and screening guidelines. An institutional and patient cost analysis was performed between CT modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of CT scans ordered and performed with contrast was greater than those without contrast both prior and post\u2010ACR 2015 guidelines. Furthermore, 79.2% of patient's final surveillance CTs after 2015 were performed with contrast. A cost analysis was performed and demonstrated an additional $297\u2009704 in patient and institutional costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At our institution, upon review of CT chest imaging for pulmonary staging and surveillance in patients with extremity sarcoma the use of contrast has been routinely utilized despite a lack of evidence for its necessity and contrary to ACR guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27510","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T01:07:58Z","timestamp":1700874478000},"page":"523-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Scrutinizing the use of contrasted chest CTs in extremity sarcoma staging and surveillance"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6954-9219","authenticated-orcid":false,"given":"Jacob I.","family":"Priester","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6441-7815","authenticated-orcid":false,"given":"Samuel K.","family":"Simister","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Sario","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiology Cardiothoracic Imaging, University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagoberto","family":"Pina","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raminta","family":"Theriault","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Ochsner Medical Center New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrus","family":"Bateni","sequence":"additional","affiliation":[{"name":"Department of Radiology, Musculoskeletal Radiology University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmadreza","family":"Ghasemiesfe","sequence":"additional","affiliation":[{"name":"Department of Radiology Cardiothoracic Imaging, University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janai","family":"Carr\u2010Ascher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"},{"name":"Department of Internal Medicine, Hematology and Oncology University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arta M.","family":"Monjazeb","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"},{"name":"Department of Radiation Oncology University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-5418","authenticated-orcid":false,"given":"Robert J.","family":"Canter","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Oncology University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-774X","authenticated-orcid":false,"given":"R. L.","family":"Randall","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3127-4912","authenticated-orcid":false,"given":"Steven W.","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California, Davis Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199905000-00002"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2016.05.005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13569-016-0060-4"},{"key":"e_1_2_7_5_1","unstructured":"National Comprehensive Cancer Network.NCCN Clinical Practice Guidelines in Oncology Bone Cancer (Version 2.2023).\u00a0National Comprehensive Cancer Network; 2022."},{"key":"e_1_2_7_6_1","unstructured":"National Comprehensive Cancer Network. 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