Integrated PET/CT in Evaluating Sarcomatous Transformation in Osteochondromas

Purandare, Nilendu; Rangarajan, Venkatesh; Agarwal, Manish; Sharma, Anshu; Shah, Sneha; Arora, Abhishek; Parasar, Deep Shankar

doi:10.1097/rlu.0b013e3181a34525

Cited by 36 publications

(20 citation statements)

References 23 publications

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“…Studies on the use of PET – CT in the study of sarcomas began to appear after 2001 (Al-Ibraheem et al 2013; Aoki et al 2001, 2003; Benz et al 2009, 2010; Brenner et al 2004; Eary et al 1998, 2002; Feldman et al 2005; Folpe et al 2000; Garcia et al 1996; Purandare et al 2009; Schulte et al 1999). Some authors suggested that because PET – CT detects hyper metabolic foci, that whole body PET – CT could be an important test for identifying chondrosarcomas and their recurrence after surgery.…”

Section: Introductionmentioning

confidence: 99%

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

et al. 2016

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The differential diagnosis between chondroma and intraosseous chondrosarcoma is based on imaging and clinical exams, but only a biopsy can confirm diagnosis. The aim of this study was to evaluate the value of PET–CT in differentially diagnosing chondroma and chondrosarcoma. From October 2009 to May 2015, 36 patients with cartilaginous bone lesions in the extremities, 12 (33.3 %) men and 24 (66.6 %) women, were prospectively included in the study. Patients ranged in age from 21 to 68 years, with a mean age of 44 years. Lesions were located in the long bones: in the proximal humerus in 26 (72.2 %) patients, in the femoral shaft in 1 (2.7 %), in the distal femur in 7 (19.4 %), and in the proximal tibia in 2 (5.5 %). The SUVmax value of 2.0 was used to separate between patients submitted to surgery and patients submitted to observation. Among the 36 patients studied, 17 (47.2 %) had SUVmax ≤ 2.0, and they were diagnosed as chondroma and they were treated conservatively. Follow-up ranged from 14 to 76 months, averaging 38 months. Nineteen (52.7 %) patients with SUVmax >2.0 were diagnosed as chondrosarcoma and underwent surgery. The area of the curve, calculated considering the SUV variable as numeric, is estimated in 0.966, with a 95 % confidence interval from 0.906 to 1.000. To evaluate the sensitivity, specificity and positive/negative predictive values, it was built a 2 × 2 table. Significance was set at p < 0.05. According the criteria of maximum sensitivity and specificity, the cut point suggested to SUVmax was 2.2. If we consider this point, it is possible to identify 19 of 36 positive cases to chondroma (52.8 %), it means, all chondrosarcomas of the series. We concluded that PET–CT can be used as an objective and quantitative method of differentiating between chondromas and chondrosarcomas located within the long bones. It represents a complementary examination to standard imaging (X-ray, scintigraphy, CT and MRI) and pathological exams. The SUVmax between 2.0 and 2.2 would be a range area between chondroma and chondrosarcoma and this range can be of value, among others exams, in decide the best treatment for patients with cartilaginous lesions in long bones.Level of evidence Level I—diagnostic study—prospectively investigating a diagnostic test using a universally applied “gold” standard.

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Section: Introductionmentioning

confidence: 99%

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

et al. 2016

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“…There are recent studies advocating PET/CT imaging to monitor known benign exostosis for malignant transformation. (10) Due to the relative rarity of these lesions it is important to review the images and histology in a specialised bone tumour multi-disciplinary meeting.…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of pseudoaneurysm formation in a patient with diaphyseal aclasis

Grainger

Stammers

Ranawat

et al. 2011

Journal of Surgical Case Reports

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A 15 year old boy, with known diaphyseal aclasis, presented with a swollen left leg. The diagnosis of popliteal pseudoaneurysm, a known and well understood vascular complication, was delayed due to presentation suggestive of a chondrosarcoma. In this age group, sarcomatous change is more common and a potentially sinister complication of diaphyseal aclasis. Following a sarcoma MDT referral, the correct diagnosis was confirmed by ultrasound and CT angiogram. This case identifies one of the largest, non-ruptured popliteal pseudoaneurysms reported and illustrates an unusual complication of a rare orthopaedic genetic condition, which is potentially limb threatening.

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“…23 A small study of 12 patients attempted to differentiate the chondrosarcoma subtypes according to their SUVmax. 24 The authors reported SUVmax 0.8e1.3 for benign cartilage tumours, 3.3e6.9 for grade 2 tumours and one patient with de-differentiated chondrosarcoma had SUV of 11.4. Because of the small numbers, it is impossible to apply these numbers generally to chondrosarcoma, but it certainly merits further study.…”

Section: The Role Of Imaging Pet-ctmentioning

confidence: 97%