Palpable Abdominal Mass-Suspected Neoplasm of fatty masses, MRI had a sensitivity of 100%, specificity of 83%, accuracy of 84%, and negative predictive value of 100% for differentiating simple lipoma from liposarcoma [40]. Although helpful in defining relationship of masses to adjacent fascia, muscles, and vessels, MRI is often not specific enough to establish a definitive diagnosis, and biopsy or excision is usually required following consultation or referral by oncologic specialists [29,38]. CT Abdomen There is little recent literature on the accuracy and diagnostic yield of CT for abdominal wall masses; however, CT is widely considered fast and accurate for excluding or confirming a mass. Because of the relative lack of soft- tissue resolution compared with MRI, it may not be a first- or second-line option for evaluation of abdominal masses. CT may be additionally helpful in the setting of suspected hernia, congenital abnormalities, hematomas, and infections [41,42]. Additionally, there may be a role in the setting of endometriosis for differentiation from other masses [43]. When malignant masses are suspected, CT may provide benefit of staging information related to metastatic disease in addition to defining the size, location, and relationship of a mass to adjacent structures. There are no recent studies that specifically address the question of whether CT should be performed with or without IV contrast for a palpable mass. Acquisition of CT both with and without contrast does not generally add diagnostic value. Although available evidence and experience generally supports the appropriateness of CT with IV contrast over that of noncontrast CT for evaluation of intra-abdominal organs and pathology [12,14,15], the use of noncontrast CT may be of value in some circumstances. CT may be of benefit in guiding biopsy and should be considered carefully and in conjunction with oncologic specialist when a sarcoma is suspected [30].
Palpable Abdominal Mass Suspected Neoplasm. Palpable Abdominal Mass-Suspected Neoplasm of fatty masses, MRI had a sensitivity of 100%, specificity of 83%, accuracy of 84%, and negative predictive value of 100% for differentiating simple lipoma from liposarcoma [40]. Although helpful in defining relationship of masses to adjacent fascia, muscles, and vessels, MRI is often not specific enough to establish a definitive diagnosis, and biopsy or excision is usually required following consultation or referral by oncologic specialists [29,38]. CT Abdomen There is little recent literature on the accuracy and diagnostic yield of CT for abdominal wall masses; however, CT is widely considered fast and accurate for excluding or confirming a mass. Because of the relative lack of soft- tissue resolution compared with MRI, it may not be a first- or second-line option for evaluation of abdominal masses. CT may be additionally helpful in the setting of suspected hernia, congenital abnormalities, hematomas, and infections [41,42]. Additionally, there may be a role in the setting of endometriosis for differentiation from other masses [43]. When malignant masses are suspected, CT may provide benefit of staging information related to metastatic disease in addition to defining the size, location, and relationship of a mass to adjacent structures. There are no recent studies that specifically address the question of whether CT should be performed with or without IV contrast for a palpable mass. Acquisition of CT both with and without contrast does not generally add diagnostic value. Although available evidence and experience generally supports the appropriateness of CT with IV contrast over that of noncontrast CT for evaluation of intra-abdominal organs and pathology [12,14,15], the use of noncontrast CT may be of value in some circumstances. CT may be of benefit in guiding biopsy and should be considered carefully and in conjunction with oncologic specialist when a sarcoma is suspected [30].