Magnetic resonance imaging of cartilaginous tumors: a retrospective study of 79 patients

Beuckeleer, L. H. L. De; Schepper, A. M. A. De; Ramon, F; Somville, Johan

doi:10.1016/0720-048x(96)81067-9

Cited by 89 publications

(36 citation statements)

References 5 publications

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“…These data agree with those of the SLICED study group [27]. Other studies have shown that the ability to diagnose cartilaginous neoplasms is improved by using a combination of imaging modalities, especially the combination of radiographs and MRI, even when increased false positive and false negative findings were observed for the latter [2,4]. Crim et al [2] found low interobserver agreement for evaluation of individual imaging criteria and for expert diagnosis based on the results of a single image modality, supporting the need for a multimodality imaging approach.…”

Section: Discussionsupporting

confidence: 82%

“…Furthermore, no specific gold standard has been developed to resolve this diagnostic challenge. Advanced imaging has been of great aid performing these diagnoses, but radiography, CT, and MRI have limitations [2,4]. In addition, even pathologists have difficulties establishing these diagnoses [27], with a lower than an desirable agreement between experts.…”

Section: Introductionmentioning

confidence: 99%

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Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Zamora

Urrutia

Schweitzer

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Distinguishing a benign enchondroma from a low-grade chondrosarcoma is a common diagnostic challenge for orthopaedic oncologists. Low interrater agreement has been observed for the diagnosis of cartilaginous neoplasms among radiologists and pathologists, but, to our knowledge, no study has evaluated inter-and intraobserver agreement among orthopaedic oncologists grading these lesions using initial clinical and imaging information. Determining such agreement is important since it reflects the certainty in the diagnosis by orthopaedic oncologists. Agreement also is important as it will guide future treatment and prognosis, considering that there is no gold standard for diagnosis of these lesions. Questions/Purposes (1) to determine inter-and intraobserver agreement among a multinational panel of expert orthopaedic oncologists in diagnosing cartilaginous neoplasms based on their assessment of clinical symptoms and imaging at diagnosis. (2) To describe the most important clinical and imaging features that experts use during the initial diagnostic process. (3) To determine interobserver agreement for proposed initial treatment strategies for cartilaginous neoplasms by this panel of evaluators. Methods Thirty-nine patients with intramedullary cartilaginous neoplasms of the appendicular skeleton of various histopathologic grades were selected and classified as having benign, low-grade malignant, or intermediate-or high-grade malignant neoplasms by 10 experienced orthopaedic oncologists based on clinical and imaging information. Additionally, they chose the three most important clinical or imaging features for the diagnosis of these neoplasms, and they proposed a treatment strategy for each patient. The Kappa coefficient (j) was used to determine inter-and intraobserver agreement. Results Inter-and intraobserver agreements were only fair to good, j = 0.44(95% CI, 0.41-0.48) and j = 0.62 (95% CI, 0.52-0.72), respectively. The three factors most frequently identified as helpful in making the diagnosis by our panel were cortical involvement in 65% of evaluations (253/390), neoplasm size in 51% (198/390), and pain in 50% (194/390). The interobserver agreement for the proposed initial treatment strategy after diagnosis was poor (j = 0.21; 95% CI, 0.18-0.24). Conclusions This study showed barely fair interobserver and fair to good intraobserver agreement for grading of intramedullary cartilaginous neoplasms by orthopaedic oncologists using initial clinical and imaging findings. These results reflect the insufficient guidance interpreting clinical and imaging features, and the limitations of the systems we use today when making these diagnoses. In the same way, they generate concern for the implications that this may have on different treatment strategies and the future prognosis of our patients. Future studies should build

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Zamora

Urrutia

Schweitzer

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Geirnaerdt et al (17) demonstrated that septonodular and peripheral rim enhancement observed on Gd-enhanced MR images supported the diagnosis of a chondroblastic osteosarcoma. However, our results demonstrate that septonodular and peripheral rim enhancement patterns are characteristic patterns for chondroid matrix-forming tumors (21,22), not exclusively for chondroblastic osteosarcomas. Therefore, these findings in Gd-enhanced MR images are not useful for the differentiation of chondroblastic osteosarcoma from chondrosarcoma.…”

Section: Discussionmentioning

confidence: 53%

Characterization of chondroblastic osteosarcoma: Gadolinium‐enhanced versus diffusion‐weighted MR imaging

Yakushiji

Oka

Sato

et al. 2009

Magnetic Resonance Imaging

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Purpose: To detect differences in magnetic resonance imaging (MRI) between chondroblastic osteosarcoma and the other types of osteosarcomas or chondrosarcomas using gadolinium-enhanced versus diffusion-weighted sequences. Materials and Methods:Contrast-enhanced MRI and diffusion-weighted imaging (DWI) were performed in five chondroblastic osteosarcoma (CO) cases, 17 other types of osteosarcomas (OS), and 18 chondrosarcomas (CS). DWI was obtained with a single-shot echo-planar imaging (EPI) sequence using a 1.5T MR imager. The apparent diffusion coefficients (ADCs) of the minimum and maximum values were also obtained. The contrast-enhancement pattern was evaluated and minimum-maximum ADC value of CO was compared with other types of OS and CS.Results: Both CO and CS showed a similar enhancement pattern; both showed septonodular and peripheral rim enhancement. The minimum ADC value of CO (1.24 Ϯ 0.10 ϫ 10 Ϫ3 mm 2 /sec) was significantly higher than that of other types of OS (0.84 Ϯ 0.15 ϫ 10 Ϫ3 mm 2 /sec) and was significantly lower than that of CS (1.64 Ϯ 0.20 ϫ 10 Ϫ3 mm 2 /sec). In addition, the maximum ADC value of CO (2.28 Ϯ 0.20 ϫ 10 Ϫ3 mm 2 /sec) was significantly higher than that of other types of OS (1.33 Ϯ 0.26 ϫ 10 Ϫ3 mm 2 /sec).Conclusion: DWI appears to be more useful for differentiating between chondroblastic osteosarcoma and chondrosarcoma or other types of osteosarcoma than Gd-enhanced MRI.

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“…Standard radiography often is sufficient to assess the extent of the tumor in the medullary canal and its relation with the cortex [5,9,14,15]. CT [24] and MRI can show whether there is endosteal involvement or breakthrough in the cortex [4,11,17].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Grade I Central Chondrosarcoma

Donati

Colangeli

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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The grade of chondrosarcoma relates to the likelihood of local recurrence and metastases. Many Grade I chondrosarcomas behave benignly if aggressively, and the question arises regarding whether wide resection is essential to control the disease. We therefore asked whether intralesional surgery also could be extended to Grade I chondrosarcomas without an increase in recurrence. We retrospectively reviewed 31 patients with Grade I chondrosarcomas of the limbs. The minimum followup was 66 months (mean, 157 months; range, 66-296 months

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Magnetic resonance imaging of cartilaginous tumors: a retrospective study of 79 patients

Cited by 89 publications

References 5 publications

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Characterization of chondroblastic osteosarcoma: Gadolinium‐enhanced versus diffusion‐weighted MR imaging

Surgical Treatment of Grade I Central Chondrosarcoma

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