Imaging of Osteoid Osteoma with Dynamic Gadolinium-enhanced MR Imaging

Liu, Patrick T.; Chivers, F. Spencer; Roberts, Catherine C.; Schultz, Christopher J.; Beauchamp, C.P.

doi:10.1148/radiol.2273020111

Cited by 171 publications

(88 citation statements)

References 21 publications

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“…These results also support the previous findings of Barei et al (36), who investigated similar items in a small series of patients. Our relatively uniform CT and preprocedural MRI patterns were in agreement with the literature (16,(37)(38)(39)(40)(41)(42), but the follow-up (mean, 3.4±2.2 months) MRI varied considerably. In Figure 4.…”

Section: Discussionsupporting

confidence: 90%

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

Rehnitz¹,

Sprengel²,

Lehner³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to retrospectively evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of patients with osteoid osteoma treated with CT-guided radiofrequency ablation (RFA) along with the clinical outcome and long-term success. MATERIALS AND METHODSSeventy-three CT-guided RFA procedures were performed in 72 patients. The long-term success was assessed using a questionnaire including several visual analog scale scores. The CT evaluation included pre-and immediate postprocedural imaging of all 72 patients, and MRI was performed in 18 patients with follow-up imaging (mean, 3.4±2.2 months). The evaluation criteria included nidus morphology and a correlation with markers of clinical success. RESULTSThe primary technique effectiveness rate was 71/72 (99%). One relapse was successfully retreated, leading to a secondary technique effectiveness rate of 72/72 (100%). The longterm follow-up (mean, 51.2±31.2 months; range, 3-109 months) revealed a highly significant reduction of all assessed limitation scores (P < 0.001). The CT morphology was typical in all cases and did not change during the short-term follow-up. The follow-up MRI patterns varied considerably, including persistent nidus contrast enhancement in one-third (6/18) and persistent marrow edema in half (9/18) of the patients. None of the investigated MRI and CT patterns correlated with the clinical outcome. CONCLUSIONThe long-term outcome of CT-guided RFA of osteoid osteoma is excellent. There is no correlation of the CT and MRI patterns with the clinical outcome. Thus, the treatment decisions should not be solely based on the imaging findings. Investigators should also be aware of the variety of imaging patterns after RFA.

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Section: Discussionsupporting

confidence: 90%

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

Rehnitz¹,

Sprengel²,

Lehner³

et al. 2013

Diagn Interv Radiol

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“…The pattern of dynamic enhancement of non-treated osteoid osteomas on MRI has been studied in detail by Liu et al [7]. They assessed the morphology or type of enhancement curve, and found that nine of 11 patients (82%) had peak enhancement of the osteoid osteoma in the early arterial phase with early partial wash-out.…”

Section: Discussionmentioning

confidence: 99%

“…The radiolucent nidus is best seen on thin slice (1 mm to 2 mm) axial CT images, because there is no overlap of surrounding reactive sclerosis and/or periosteal reaction [3][4][5]. More recent papers have focused on the appearance of osteoid osteoma on magnetic resonance imaging (MRI), describing the morphology of the nidus, the surrounding bone, and the adjacent soft tissues, as well as the enhancement pattern of the nidus during dynamic MRI imaging [6,7].…”

Section: Introductionmentioning

confidence: 99%

The healing pattern of osteoid osteomas on computed tomography and magnetic resonance imaging after thermocoagulation

et al. 2007

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Objective To compare the healing pattern of osteoid osteomas on computed tomography (CT) and magnetic resonance imaging (MRI) after successful and unsuccessful thermocoagulation. Materials and methods Eighty-six patients were examined by CT and 18 patients by dynamic gadolinium-enhanced MRI before and after thermocoagulation for osteoid osteoma. Thermocoagulation was successful in 73% (63/86) and unsuccessful in 27% (23/86) of patients followed by CT. Thermocoagulation was successful in 72% (13/18) of patients followed by MRI. After treatment, the healing of the nidus on CT was evaluated using different healing patterns (complete ossification, minimal nidus rest, decreased size, unchanged size or thermonecrosis). On MRI the presence of reactive changes (joint effusion, "oedema-like" changes of bone marrow and soft tissue oedema) and the delay time (between arterial and nidus enhancement) were assessed and compared before and after thermocoagulation. Results Complete ossification or a minimal nidus rest was observed on CT in 58% (16/28) of treatment successes (with > 12 months follow-up), but not in treatment failures. "Oedema-like" changes of bone marrow and/or soft tissue oedema were seen on MR in all patients before thermocoagulation and in all treatment failures. However, residual "oedema-like" changes of bone marrow were also found in 69% (9/13) of treatment successes. An increased delay time was observed in 62% (8/13) of treatment successes and in 1/5 of treatment failures. Conclusion Complete, or almost complete, ossification of the treated nidus on CT correlated with successful treatment. Absence of this ossification pattern, however, did not correlate with treatment failure. CT could not be used to identify the activity of the nidus following treatment. The value of MR parameters to assess residual activity of the nidus was limited in this study.

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“…Its application in musculoskeletal radiology is mainly limited to the assessment of tumors (18)(19)(20). Information about the vascularity and…”

Section: Patientsmentioning

confidence: 99%

Is Dynamic Gadolinium Enhancement Needed in MR Imaging for the Preoperative Assessment of Scaphoidal Viability in Patients with Scaphoid Nonunion?

Donati¹,

Zanetti²,

Nagy³

et al. 2011

Radiology

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rrmann , MD Purpose:To compare the accuracy of dynamic gadolinium-enhanced magnetic resonance (MR) imaging with that of standard MR imaging for assessing the viability of the proximal pole of the scaphoid in patients with nonunion. Materials and Methods:The study protocol was submitted to the institutional review board, and the need to obtain additional approval was waived for this retrospective study. Twenty-eight patients (mean age 6 standard deviation, 24.3 years 6 6.4) with nonunion of a scaphoid fracture underwent dynamic gadolinium-enhanced MR imaging of the wrist 28 days 6 19 before surgery. Dynamic gadolinium-enhanced MR imaging consisted of acquisition of 40 consecutive coronal T1-weighted images over 1 minute. Two readers retrospectively evaluated MR images obtained with a standard protocol and rated the viability of the proximal scaphoid pole. The steepest upslope of gadolinium uptake was calculated in a region of interest placed in the proximal scaphoid pole by a third reader. Receiver operating characteristic curves were calculated, and the areas under the receiver operating characteristic curve ( A z values) were compared. Diagnostic performance in determining scaphoid viability was calculated for readers 1 and 2. Histologic fi ndings in 11 patients and surgical fi ndings in all patients served as the standard of reference. Results:The sensitivity, specifi city, and accuracy of standard MR imaging in the detection of scaphoid necrosis were 54%, 93%, and 75%, respectively, for reader 1 and 62%, 93%, and 78% for reader 2. Interreader reliability was excellent ( k = 0.92). The A z was 0.82 for reader 1 and 0.87 for reader 2. The diagnostic performance of dynamic gadolinium-enhanced MR imaging, determined with the steepest upslope value, was inferior to that of standard MR imaging, with an A z of 0.57. Findings at histologic examination (viable bone, necrotic bone, callus formation) did not correlate with those at dynamic gadolinium-enhanced MR imaging. Conclusion:Because the diagnostic performance of dynamic gadoliniumenhanced MR imaging in the evaluation of scaphoid viability was inferior to that of a standard MR imaging protocol, dynamic acquisition may not be needed in patients with nonunion of scaphoid fractures.q RSNA, 2011

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Imaging of Osteoid Osteoma with Dynamic Gadolinium-enhanced MR Imaging

Abstract: Osteoid osteomas can be imaged with greater conspicuity by using dynamic gadolinium-enhanced instead of nonenhanced MR imaging and with conspicuity equal to or better than that obtained with thin-section CT.

Cited by 171 publications

References 21 publications

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

The healing pattern of osteoid osteomas on computed tomography and magnetic resonance imaging after thermocoagulation

Is Dynamic Gadolinium Enhancement Needed in MR Imaging for the Preoperative Assessment of Scaphoidal Viability in Patients with Scaphoid Nonunion?

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