Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network

Objective: Osteosarcoma is a highly malignant bone tumor with a high incidence of lung metastases (LM), significantly impacting the 5-year survival rate of patients. This study aims to predict lung metastasis in osteosarcoma based on computed tomography angiography (CTA) signs. Methods: A retrospect...

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Main Authors: Zhendong Luo, Tao Ai, Zhiqiang Liu, Litong He, Yanzhen Hou, Yulin Li, Ziyan Zhou, Xinping Shen
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Bone Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2212137425000284
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author Zhendong Luo
Tao Ai
Zhiqiang Liu
Litong He
Yanzhen Hou
Yulin Li
Ziyan Zhou
Xinping Shen
author_facet Zhendong Luo
Tao Ai
Zhiqiang Liu
Litong He
Yanzhen Hou
Yulin Li
Ziyan Zhou
Xinping Shen
author_sort Zhendong Luo
collection DOAJ
description Objective: Osteosarcoma is a highly malignant bone tumor with a high incidence of lung metastases (LM), significantly impacting the 5-year survival rate of patients. This study aims to predict lung metastasis in osteosarcoma based on computed tomography angiography (CTA) signs. Methods: A retrospective study was conducted involving 89 consecutive patients with osteosarcoma. Clinical features and CTA signs, including age, gender, laterality, primary site, type of bone destruction, T stage, periosteal reaction, tumor length, bone marrow involved length, vascular wrapping, and intratumoral vascular network, were evaluated. Univariate and multivariate logistic regression analyses were used to identify risk factors for LM, followed by receiver operating characteristic (ROC) curve analysis. Results: The vascular wrapping and intratumoral vascular network signs were more frequently observed in LM in patients with osteosarcoma (P < 0.05). The intratumoral vascular network remained an independent risk factor in multivariable regression analysis. ROC curve analysis demonstrated that the area under the curve (AUC) of the logistic regression model was 0.804, indicating good predictive accuracy. Conclusion: Preliminary findings suggest that CTA signs, particularly vascular wrapping and the intratumoral vascular network, may have potential utility in predicting lung metastasis (LM) in osteosarcoma patients. The intratumoral vascular network, in particular, was identified as an independent risk factor.
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spelling doaj-art-70de6d2bfca845d1ad9d2c24f7fca1962025-08-20T02:05:49ZengElsevierJournal of Bone Oncology2212-13742025-06-015210068710.1016/j.jbo.2025.100687Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular networkZhendong Luo0Tao Ai1Zhiqiang Liu2Litong He3Yanzhen Hou4Yulin Li5Ziyan Zhou6Xinping Shen7Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, PR ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR ChinaDepartment of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, PR ChinaDepartment of Radiology, Peking University Shenzhen Hospital, Shenzhen, PR ChinaDepartment of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, PR ChinaDepartment of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, PR China; Corresponding author at: Department of Radiology, The University of Hong Kong - Shenzhen Hospital, No.1, Haiyuan road Futian District, Shenzhen 518000, PR China.Objective: Osteosarcoma is a highly malignant bone tumor with a high incidence of lung metastases (LM), significantly impacting the 5-year survival rate of patients. This study aims to predict lung metastasis in osteosarcoma based on computed tomography angiography (CTA) signs. Methods: A retrospective study was conducted involving 89 consecutive patients with osteosarcoma. Clinical features and CTA signs, including age, gender, laterality, primary site, type of bone destruction, T stage, periosteal reaction, tumor length, bone marrow involved length, vascular wrapping, and intratumoral vascular network, were evaluated. Univariate and multivariate logistic regression analyses were used to identify risk factors for LM, followed by receiver operating characteristic (ROC) curve analysis. Results: The vascular wrapping and intratumoral vascular network signs were more frequently observed in LM in patients with osteosarcoma (P < 0.05). The intratumoral vascular network remained an independent risk factor in multivariable regression analysis. ROC curve analysis demonstrated that the area under the curve (AUC) of the logistic regression model was 0.804, indicating good predictive accuracy. Conclusion: Preliminary findings suggest that CTA signs, particularly vascular wrapping and the intratumoral vascular network, may have potential utility in predicting lung metastasis (LM) in osteosarcoma patients. The intratumoral vascular network, in particular, was identified as an independent risk factor.http://www.sciencedirect.com/science/article/pii/S2212137425000284Computed tomography angiographyPredictive value of testsOsteosarcomaMetastasis
spellingShingle Zhendong Luo
Tao Ai
Zhiqiang Liu
Litong He
Yanzhen Hou
Yulin Li
Ziyan Zhou
Xinping Shen
Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
Journal of Bone Oncology
Computed tomography angiography
Predictive value of tests
Osteosarcoma
Metastasis
title Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
title_full Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
title_fullStr Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
title_full_unstemmed Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
title_short Predicting lung metastasis in high-grade osteosarcoma: The role of computed tomography angiography (CTA) signs with a focus on vascular wrapping and the intratumoral vascular network
title_sort predicting lung metastasis in high grade osteosarcoma the role of computed tomography angiography cta signs with a focus on vascular wrapping and the intratumoral vascular network
topic Computed tomography angiography
Predictive value of tests
Osteosarcoma
Metastasis
url http://www.sciencedirect.com/science/article/pii/S2212137425000284
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