Midterm MRI Follow-Up of Untreated Enchondroma and Atypical Cartilaginous Tumors in the Long Bones (original) (raw)
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European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2017
The purpose of our study is to verify possible clinical and radiological findings with regard to distinguishing enchondroma from atypical cartilaginous tumour (ACT). In addition, this study determined risk factors that are associated with local recurrence of enchondroma or ACT treated with curettage. We retrospectively reviewed the records of 54 patients with enchondroma and 35 patients with ACT of the long bones treated by curettage between 1986 and 2015. The minimum follow-up was 18 months. The relationship between clinical and radiological factors and the tumour type or local recurrence was assessed using Chi-square test or Fischer exact test. Endosteal scalloping (p = 0.004) and soft tissue extension (p = 0.017) were shown to statistically favour ACT over enchondroma; by contrast, pain (p = 0.034) was more frequent in enchondroma compared to ACT. All patients with enchondroma had no local recurrence; in contrast, local recurrence occurred in four patients with ACT (11%). Soft ti...
Magnetic resonance imaging of cartilaginous tumors: a retrospective study of 79 patients
European Journal of Radiology, 1995
Objective: Hyaline cartilaginous tumors are characterized by extremely high signal intensity on T2-weighted images. Recently, some distinctive MR features of cartilaginous bone tumors were reported in small series. Low signal intensity septa surrounding high signal intensity cartilage lobules were seen on T2-weighted images in low-grade chondrosarcomas. On spin-echo Tl-weighted images after Gd contrast injection, marked 'septal' or 'ring-and-arc' enhancement was observed in low-grade chondrosarcomas and enchondromas. The purpose of this study was to determine sensitivity and specificity of these MR findings in diagnosis of cartilaginous tumors, and to assess the value of MR in diagnostic workup of these lesions. Materials and methods: Retrospective evaluation of MR findings in 79 cartilaginous tumors and in 79 non-cartilaginous tumors. All lesions were biopsy proven. Each MR examination was independently reviewed by two experienced radiologists without knowledge of clinical data, radiographic and/or CT findings, or histological diagnosis. All lesions were evaluated for morphology (lobular or non-lobular), presence of a high signal intensity mass on T2-weighted images, presence of low signal intensity septa separating high signal intensity lobules on T2-weighted images, and evidence of septal ('ring-and-arc') enhancement. Results: None of the reviewed parameters is useful in diagnosing osteochondromas. Since osteochondromas have a characteristic appearance on plain radiography, the value of MR imaging in the workup of these lesions remains limited. MR findings in enchondromas have a low specificity and a low sensitivity. Low-grade chondrosarcomas, often hard to diagnose on plain radiography and difficult to differentiate from enchondromas, are characterized by the MR tandem of'low signal intensity septa on T2-weighted images' together with 'septal or ring-and-arc enhancement' (sensitivity 92.3%, specificity 76.5%). High-grade chondrosarcomas are easily recognized on plain radiography. Conclusions: In differentiating cartilaginous from non-cartilaginous tumors, MR features are highly specific but lack sensitivity. Grading potentials of MR parameters are promising due to the high accuracy in diagnosing low-grade chondrosarcomas.
Magnetic resonance imaging of cartilaginous tumors: is it useful or necessary?
Skeletal radiology, 1996
A retrospective study was undertaken to compare the diagnostic accuracy of plain radiography and magnetic resonance (MR) imaging in the diagnosis of cartilaginous tumors. The study population consisted of 68 patients with a histologically proven cartilaginous tumor. For each lesion, a comparative analysis of "plain radiography" versus "plain radiography together with MR study" was performed by two radiologists together. Recently reported literature data were used as criteria by which to define accuracy rating. MR imaging improves accuracy in diagnosing low-grade chondrosarcomas. Since osteochondromas have a characteristic appearance on plain films, MR imaging contributes only in the diagnostic workup of cases in which malignant transformation is suspected.
18F-FDG PET/CT in the evaluation of cartilaginous bone neoplasms: the added value of tumor grading
Annals of Nuclear Medicine, 2019
Objectives Cartilaginous bone tumors represent a wide variety of neoplasms ranging from benign to extremely aggressive malignant lesions. Unlike other tumors, the biopsy cannot easily predict the histological grade, sometimes not allowing choosing the best therapeutic approach. The aim of the study was to evaluate the ability of 18 F-FDG PET/CT to differentiate enchondroma from chondrosarcoma and to predict the histological grade as compared to biopsy. Methods 18 F-FDG PET/CT of 95 patients with chondroid lesions were retrospectively evaluated. The best SUV max cutoff to predict the post-surgical histological grade were correlated to those of biopsy and to several radiologic aggressiveness features, which were summarized in the parameter "Radiologic Aggressiveness Score" (AgSCORE). Results A concordance between the preoperative biopsy and the definitive histological grade was observed overall in 78.3% of patients, the lowest accuracy (58.6%) being in the identification of intermediate/high-grade chondrosarcoma (G2/G3). The best SUV max cutoff was 2.6 to discriminate enchondroma vs. low-grade chondrosarcoma (sensitivity 0.68, specificity 0.86), 3.7 to differentiate low-grade vs. intermediate/high-grade chondrosarcoma (sensitivity 0.83, specificity 0.84) and 7.7 to differentiate intermediate/high-grade vs. dedifferentiated chondrosarcoma (sensitivity 0.92, specificity 0.9). The AgSCORE also showed a high accuracy to differentiate between G1 and G2/G3 chondrosarcoma (cutoff = 4; sensitivity 0.76; specificity 0.89). An even higher accuracy was observed in those cases in which both SUV max and AgSCORE cutoff were concordant. Conclusions Results in this large series of patients suggest a potential role of 18 F-FDG PET/CT for histological grading of cartilaginous tumors, thus helping the orthopedic surgeon towards the most appropriate surgical procedure.
Tumeurs cartilagineuses et lésions calcifiées de la main : revue iconographique
Journal de Radiologie Diagnostique et Interventionnelle, 2013
Cartilaginous tumours of the extremities are commonly seen in radiographs. Enchondroma is the most frequently encountered tumour. Since the vast majority of enchondromas are asymptomatic, they are typically discovered as incidental findings or along with a pathologic fracture. The authors propose a pictorial review to illustrate the imaging features of cartilaginous bone lesions of the hand and their specificities, and discuss the main differential diagnoses.
Benign Cartilaginous Tumors of Bone
Advances in Anatomic Pathology, 2009
Benign cartilaginous tumors of bones, intrinsic to their name, are tumors forming cartilaginous matrix with a clinically benign behavior. In this group, we recognize osteochondromas, (en)chondromas, chondroblastomas, and chondromyxoid fibromas. This group includes common tumors, that is, osteochondroma and (en)chondroma as well as rare tumors such as chondroblastoma and chondromyxoid fibroma. Several benign and malignant tumors may mimic benign cartilaginous tumors of bones. We reviewed the main morphologic features and the differential diagnosis is discussed. The genetics of these tumors is intriguing ranging from single gene event (ie, EXT mutation in multiple osteochondromas) to heterogeneous rearrangements with no recurrent involved chromosomal regions such as in chondroblastoma. The main genetic findings are hereby reviewed.
Quantitative bone SPECT/CT applications for cartilaginous bone neoplasms
Hellenic Journal of Nuclear Medicine, 2020
Objective: To evaluate the ability of quantitative values obtained with bone single photon emission computed tomography/computed tomography (SPECT/CT) to differentiate benign from malignant cartilaginous bone neoplasms. Subjects and methods: Bone SPECT/CT scans of 10 patients with 8 benign cartilaginous bone neoplasms (4 enchondromas, 1 periosteal chondroma, 1 osteochondroma, 1 bizarre parosteal osteochondromatous proliferation, 1 chondroblastoma) and 2 malignant cartilaginous bone neoplasms (1 periosteal chondrosarcoma, 1 chondrosarcoma) were retrospectively analyzed with maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic bone volume (MBV), and total bone uptake (TBU) of primary lesions. Results: Mean SUVmax of 8 benign and 2 malignant cartilaginous bone neoplasms were 1.93±1.02 (range 0.59-3.41) and 6.07±0.86 (5.46-6.67), respectively with no overlap (P=0.028). Mean SUVmean of those were 1.24±0.71 (range 0.36-2.36) and 4.05±0.30 (3.84-4.26), respectively with no overlap (P=0.00036). Mean MBV of those were 7.17±4.19 (range 3.17-13.77) and 10.29±10.05 (3.19-17.4), respectively with no significant difference (P=0.74). Mean TBU of those were 9.22±8.31 (range 1.15-23.61) and 43.19±43.7 (12.26-74.13), respectively with no significant difference (P=0.47). Conclusion: Standardized uptake value obtained with bone SPECT/CT may be useful to differentiate benign from malignant cartilaginous bone neoplasms, thus helping the orthopedic surgeon towards the most appropriate treatment procedure.