Accuracy of MRI scans in predicting intra-articular joint involvement in high-grade sarcomas around the knee

Kurisunkal, Vineet; Morris, Guy; Kaneuchi, Yoichi; Bleibleh, Sabri; James, Steven; Botchu, Rajesh; Jeys, Lee; Parry, Michael

doi:10.1302/0301-620x.105b6.bjj-2022-0068.r2

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…To improve the diagnosis of teased difficult lesions, a team from Birmingham (UK) sought to evaluate the accuracy of MRI in predicting IA involvement around the knee. 3 The authors assembled a cohort of 63 cases of high-grade sarcomas in or around the distal femur that underwent an EA resection, and suspicion of IA disease was noted in 52 cases. Six patients showed IA pathological fracture, two an effusion, two prior surgical interventions (curettage/IA intervention), and one an osseous metastasis in the proximal tibia.…”

Section: Accuracy Of Mri Scans In Predicting Intra-articular Joint In...mentioning

confidence: 99%

Oncology

2023

Bone &Amp; Joint 360

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The October 2023 Oncology Roundup360 looks at: Are pathological fractures in patients with osteosarcoma associated with worse survival outcomes?; Spotting the difference: how secondary osteosarcoma manifests in retinoblastoma survivors versus conventional cases; Accuracy of MRI scans in predicting intra-articular joint involvement in high-grade sarcomas around the knee; Endoprosthetic reconstruction for lower extremity soft-tissue sarcomas with bone involvement; Local relapse of soft-tissue sarcoma of the extremities or trunk wall operated on with wide margins without radiation therapy; 3D-printed, custom-made prostheses in patients who had resection of tumours of the hand and foot; Long-term follow-up for low-grade chondrosarcoma; Evaluation of local recurrence and diagnostic discordance in chondrosarcoma patients undergoing preoperative biopsy; Radiological scoring and resection grade for intraosseous chondrosarcoma.

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Section: Accuracy Of Mri Scans In Predicting Intra-articular Joint In...mentioning

confidence: 99%

Oncology

2023

Bone &Amp; Joint 360

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Association of MRI findings with intra-articular tumour extension

Deveza,

El Amine,

Becker

et al. 2024

Bone Jt Open

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AimsTreatment of high-grade limb bone sarcoma that invades a joint requires en bloc extra-articular excision. MRI can demonstrate joint invasion but is frequently inconclusive, and its predictive value is unknown. We evaluated the diagnostic accuracy of direct and indirect radiological signs of intra-articular tumour extension and the performance characteristics of MRI findings of intra-articular tumour extension.MethodsWe performed a retrospective case-control study of patients who underwent extra-articular excision for sarcoma of the knee, hip, or shoulder from 1 June 2000 to 1 November 2020. Radiologists blinded to the pathology results evaluated preoperative MRI for three direct signs of joint invasion (capsular disruption, cortical breach, cartilage invasion) and indirect signs (e.g. joint effusion, synovial thickening). The discriminatory ability of MRI to detect intra-articular tumour extension was determined by receiver operating characteristic analysis.ResultsOverall, 49 patients underwent extra-articular excision. The area under the curve (AUC) ranged from 0.65 to 0.76 for direct signs of joint invasion, and was 0.83 for all three combined. In all, 26 patients had only one to two direct signs of invasion, representing an equivocal result. In these patients, the AUC was 0.63 for joint effusion and 0.85 for synovial thickening. When direct signs and synovial thickening were combined, the AUC was 0.89.ConclusionMRI provides excellent discrimination for determining intra-articular tumour extension when multiple direct signs of invasion are present. When MRI results are equivocal, assessment of synovial thickening increases MRI’s discriminatory ability to predict intra-articular joint extension. These results should be interpreted in the context of the study’s limitations. The inclusion of only extra-articular excisions enriched the sample for true positive cases. Direct signs likely varied with tumour histology and location. A larger, prospective study of periarticular bone sarcomas with spatial correlation of histological and radiological findings is needed to validate these results before their adoption in clinical practice.Cite this article: Bone Jt Open 2024;5(10):944–952.

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What’s New in Musculoskeletal Tumor Surgery

Gazendam,

Ghert

2024

Journal of Bone and Joint Surgery

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This past year, the musculoskeletal tumor surgery literature kept up with the rapidly increasing publication volume in the medical literature. Among the thousands of publications in our field, we highlight a chosen few in this Guest Editorial. We are excited to present remarkable collaborations and exciting innovations. Although the majority of research continues to be retrospective, unique approaches are being developed and international cohesion is apparent by the worldwide collaborations and sharing of prospective data sets. Molecular approaches to diagnosis and treatment have made incremental steps forward, and the use of machine learning in prognosis and diagnosis continues to make strides. Finally, surgical approaches to bone and soft-tissue tumors are becoming better understood through large case series. Soft-Tissue Sarcoma Prognostic Prediction ModelsRecent research has emphasized the crucial role of advanced diagnostic tools and methodologies in improving the prognosis and management of soft-tissue sarcomas. Marques et al. explored how magnetic resonance imaging (MRI) can predict the histological grade of soft-tissue sarcomas, suggesting that MRI features can provide valuable preoperative insights, potentially guiding treatment strategies 1 . Similarly, Kim et al. explored DNA methylation profiling as a means to classify histologic subtypes and grades in soft-tissue sarcomas 2 . Their findings indicate that this molecular approach can complement traditional histopathological evaluation, enhancing diagnostic accuracy and personalized treatment planning.Survival prediction models are also gaining attention. Yeramosu et al. developed a model to predict 5-year mortality in patients with soft-tissue sarcoma, emphasizing factors such as tumor size, patient age, and histological grade 3 . Kamalapathy et al. introduced a machine learning algorithm specifically for predicting 5-year survival in patients with soft-tissue leiomyosarcoma, highlighting the potential of artificial intelligence in clinical decision-making 4 . Additionally, Stauss et al. examined the impact of surgical resection margins on outcomes such as local recurrence, distant metastasis, and overall survival, underscoring the importance of achieving clear margins during the surgical procedure to improve patient prognosis 5 . Although the risk factors identified in these prediction model studies are not new, big data and the machine learning approach are important advancements. Specific Soft-Tissue Sarcoma SubtypesAn increasing number of studies are approaching soft-tissue sarcoma subtypes as unique entities. In a Phase-2, international, open-label trial (SPEARHEAD-1), D'Angelo et al. investigated the efficacy of afamitresgene autoleucel in patients with advanced synovial sarcoma and myxoid round cell liposarcoma 6 . The study demonstrated promising results, with a notable percentage of patients experiencing tumor reduction and manageable safety profiles. This innovative therapy, which involves engineered T-cells targeting specific cancer antigens,...

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Accuracy of MRI scans in predicting intra-articular joint involvement in high-grade sarcomas around the knee

Cited by 3 publications

References 17 publications

Oncology

Oncology

Association of MRI findings with intra-articular tumour extension

What’s New in Musculoskeletal Tumor Surgery

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