Abstract
Introduction: Conventional teaching identifies that the ultimate responsibility for definitive diagnosis of bone tumour resides with the pathologist. But the radiologist has the added advantage of viewing the lesion in a bigger canvas using the different imaging modalities. Despite newer imaging techniques, radiograph is the preliminary and single most important imaging investigation. MR imaging helps to confirm the diagnosis, determine the focal extent and local staging of the tumour for its effective treatment and follow up. However false positive diagnosis may lead to over staging of tumour and result in unnecessarily radical surgical procedures. This study is meant to assess the sensitivity, specificity, positive predictive value and negative predictive value of MRI findings in bone tumours using surgical and pathological findings as reference standard.
Methodology: The study was a descriptive study with diagnostic test evaluation. The study population included all patients clinically suspected of bone tumour referred for MRI evaluation from orthopaedics department to Department of Radiodiagnosis, Govt. T.D. Medical College, Alappuzha. MRI findings were evaluated to look for marrow, soft tissue, joint, neurovascular bundle, and cortical involvement. The obtained data from MRI findings were compared with surgical and pathological findings by statistical analysis.
Results: MRI shows high sensitivity of 100% in detection of marrow, soft tissue, joint and neurovascular bundle involvement and 97.4% in the detection of cortical involvement and specificity of 87.5%, 70.6%, 95%, 98.2% and 100% respectively in detection of marrow, soft tissue, joint, neurovascular bundle and cortical involvement; in comparison with surgical and pathological findings.
Conclusion: MR imaging is highly sensitive and specific in assessing the extent of involvement of bone tumour and thus aids in its treatment.
Keywords: MR imaging; bone tumour.
References
- van der Woude HJ, Bloem JL, Hogendoorn PC. Preoperative evaluation and monitoring chemotherapy in patients with high-grade osteogenic and Ewing's sarcoma: review of current imaging modalities. Skeletal Radiol 1998; 27:57–71
- Moser RP, Madewell JE. An approach to primary bone tumors. Radiol Clin North Am 1987; 25:1049−1093.
- Daffner RH, Lupetin AR, Dash N, Deeb ZL, Sefczek RJ, Schapiro RL. MRI in the detection of malignant infiltration of bone marrow. AJR Am J Roentgenol. 1986 Feb;146(2):353-8.
- Wolfgang Schima, Gabriele Amann. Preoperative staging of osteosarcoma Efficacy of MR imaging in detecting joint involvement AJR 1994 ;163 :1171-1175.
- Baweja S, Arora R, Singh S, Sharma A, Narang P, Ghuman S, Kapoor S K, Puri S. Evaluation of bone tumors with magnetic resonance imaging and correlation with surgical and gross pathological findings. Indian J Radiol Imaging 2006 ;16:611-8.
- Lang P, Grampp S, Vahlensieck M, et al. Primary bone tumors: value of MR angiography for preoperative planning and monitoring response to chemotherapy. AJR Am J Roentgenol 1995;165:135–142.
- Thomas H Berquist. Magnetic resonance Imaging of Primary skeletal neoplasms, Radiologic clinics of North America March 1993 31;2 :411423.
- Gregory S. Stacy, Ravinder S. Mahal, and Terrance D. Peabody; Staging of Bone Tumors: A Review with Illustrative Examples ; American Journal of Roentgenology 2006 186:4, 967-976.
- Ladd ME. High-field-strength magnetic resonance: potential and limits. Top Magn Reson Imaging 2007;18:139−152.
- Gold GE, Han E, Stainsby J, Wright G, Brittain J, Beaulieu C. Musculoskeletal MRI at 3.0 T: relaxation times and image contrast. Am J Roentgenol2004; 183:343−351.
- Baur A, Reiser MF. Diffusion-weighted imaging of the musculoskeletal system in humans. Skeletal Radiol 2000; 29:555−562.
- Hayashida Y, Yakushiji T, Awai K, Katahira K, Nakayama Y, Shimomura O, Kitajima M, Hirai T, Yamashita Y, Mizuta H. Monitoring therapeutic responses of primary bone tumors by diffusionweighted image: initial results. Eur Radiol 2006,16:2637−264.
- JL Bloem, HJ vander woude, Does magnetic resonance imaging make a difference for patients with musculoskeletal sarcoma? The British Journal of Radiology 1997;70:327-337.
- Michiel F Van Trommel, Herman M Kroon, MR imaging based strategies in limb salvage surgery for osteosarcoma of the distal femur, Skeletal Radiology 1997;26:636-64.
Corresponding Author
Dr Suma Job
Department of Radiodiagnosis, Government T.D. Medical College,
Alappuzha, Kerala, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.129
