ACR Appropriateness Criteria® Primary Bone Tumors

Imaging, Expert Panel on Musculoskeletal; Bestic, Joseph M.; Wessell, Daniel E.; Beaman, Francesca D.; Cassidy, R. Carter; Czuczman, Gregory J.; Demertzis, Jennifer L.; Lenchik, Leon; Motamedi, Kambiz; Pierce, Jennifer L.; Sharma, Akash; Sloan, Andrew E.; Than, Khoi D.; Walker, E. Ronald; Yung, Elizabeth; Kransdorf, Mark J.

doi:10.1016/j.jacr.2020.01.038

Cited by 34 publications

(67 citation statements)

References 45 publications

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“…In our study, we found that the presence of a soft-tissue mass (tumoral enhancement) was a feature strongly indicating aggressive bone lesions (P<0.001) (Figs. [1][2][3]. A soft-tissue mass is an essential sign of predicting bony malignancy, particularly in some tumors such as Ewing's sarcoma and osteosarcoma (7).…”

Section: Discussionmentioning

confidence: 99%

“…Plain radiographs are always the initial investigation of a patient with a bone lesion. This modality can effectively differentiate the aggressiveness of a bone lesion, which precisely predicts the pathological findings (3)(4)(5)(6)(7). They are also available and cost-effective in most healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

“…computed tomography [CT] scan or magnetic resonance imaging [MRI]) are necessary to provide further information for an accurate diagnosis. Advances in current technology have made the MRI more accessible in many levels of healthcare facilities and more involved in diagnosing bone lesions and therapeutic planning, as well as monitoring disease progression (3,7,13,14). This modality provides an advantage in demonstrating bone marrow, which assists radiologists and clinicians in differentiating between benign or malignant bone lesions (7).…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging in differentiating between aggressive and non-aggressive bone tumors

et al. 2022

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Background While radiography remains essential in the initial evaluation of bone lesions, tissue biopsy or further imaging is often required to clarify indeterminate radiographic features. Magnetic resonance imaging (MRI) assists radiologists in evaluating lesions with indeterminate features as it has advantages in delineating tumorous tissues and bone marrow. Purpose To evaluate the association factors of MRI for bony aggressiveness. Material and Methods A retrospective analysis of 226 MRI examinations from patients diagnosed with bone tumors in a tertiary hospital during 2008–2018 was performed. All the MR images were interpreted by musculoskeletal radiologists without diagnostic information. The bony lesions were categorized into aggressive and non-aggressive groups using tumor margin, cortical changes, periosteal reaction, joint extension, extraosseous soft tissue involvement, tumor homogeneity, and enhancement pattern from the MR images. Univariable and multivariable analysis were applied for each feature on the MRI scans. In addition, sensitivity and specificity were calculated for MRI diagnoses of aggressive bone lesions. Results In total, 180 aggressive and 46 non-aggressive bone lesions were examined on MRI. The sensitivity and specificity of MRI for differentiating between aggressive and non-aggressive bone lesions were 98.89% and 50%, respectively. Ill-defined margin, cortical break, cortical signal changes, sunburst and Codman's triangle periosteal reaction, joint extension, and tumoral and heterogeneous enhancement could be predictive signs for aggressive bone lesions. Conclusion MRI can be a valuable tool to assist in distinguishing aggressive from non-aggressive bone lesions. In cases of indeterminate radiographic features, MRI could be used as an additional imaging to improve diagnostic accuracy and could reduce unnecessary invasive procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging in differentiating between aggressive and non-aggressive bone tumors

et al. 2022

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“…At a minimum, radiography should be performed for all primary bone tumor cases. 11 12 It may be necessary to perform a combination of various imaging modalities in attempts to completely characterize and evaluate a lesion. Additional examinations, such as diagnostic intra-articular injection or arthrography, can be useful adjuncts in certain circumstances.…”

Section: Preprocedural Planning and Biopsy Techniquementioning

confidence: 99%

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Mills

Leake

Crawford

et al. 2021

Semin Musculoskelet Radiol

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Imaging-guided needle biopsy of musculoskeletal lesions is a high-yield and low-risk procedure that can be used for definitive characterization of indeterminate bone and soft tissue lesions. Familiarity with the preprocedural, technical, and postprocedural steps is vital for the appropriate management of these cases. Biopsy request triage requires an awareness of definitively benign conditions and other tumor mimics. A complete clinical, laboratory, and imaging work-up is essential for procedural planning and determining pathologic concordance. Consultation with an orthopaedic oncologist is a requisite step to ensure maximizing biopsy yield and to avoid interference with any future limb-sparing surgical intervention. Knowledge of the equipment, pertinent medications, and appropriate biopsy technique can minimize the risk of periprocedural complications. Finally, the radiologist may be required to discuss the concordance of histopathology with preprocedure imaging, perform repeat image-guided biopsy, and carefully interpret sarcoma surveillance imaging examinations.

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“…The primary method for evaluating a bone tumors and tumor-like lesions is conventional radiograph. Whenever a bony pathology is detected that cannot be characterized and shows features of aggressive pathology MRI is indicated 1 . The excellent contrast resolution and multiplanar capabilities of MRI has led to much superior evaluation of intra-S208 compartmental and extra compartmental extent of bone tumor, particularly with extension of tumor into the perilesional muscles, neurovascular bundle, displacement or invasion of adjacent fat planes, extent of bone marrow involvement, degree of intra-articular extension and presence of intra-tumoral necrosis and haemorrhage 2 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Magnetic Resonance Imaging in Diagnosing Bone Tumors Keeping Histopathological Correlation as Gold Standard

Farooq

Zameer

Khadim

et al. 2021

PAFMJ

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Objective: To determine the diagnostic accuracy of magnetic resonance imaging in diagnosing bone tumorskeeping histopathological as correlation gold standard. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Departments of Radiology, Orthopedics and Pathology of Pakistan Institute ofMedical Sciences, Islamabad, from Jan 2018 to Jan 2019. Methodology: All the patients who had complain of bone deformity or pain with high suspicion of neoplasticpathology involving bone and soft tissue on radiograph were included in study. Patients were first diagnosed on conventional radiography followed by magnetic resonance imaging. Magnetic resonance imaging with contrast was done on Phillips 1.5 tesla machine. T1W, T2W, STIR images, Fat suppressed, PD spair and post contrast T1W images were obtained. Positive magnetic resonance imaging findings which were noted were; marrow involvement, cortical break, soft tissue involvement, joint involvement, neurovascular bundle involvement and post contrast enhancement on T1W imaging. Then bone biopsy was performed. The removed bone was sent for histopathological examination in all cases. The histopathological reports were collected. The results were entered in structured proformas. Data was collected after the informed consent. All the data was entered and analyzed using SPSS version-23. Results: Fifty patients of both genders were recruited during our study duration. 32 (64.0%) were male while 18(36.0%) were female patients. Mean age of the patient was 54.5 ± 14.3 years with range 18 to 80 years. Among the benign tumors vertebral hemangiomas were most commonly found 5 (10.0%) followed by osteochondroma which was 4 (8.0%), while among malignant........

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ACR Appropriateness Criteria® Primary Bone Tumors

Cited by 34 publications

References 45 publications

Magnetic resonance imaging in differentiating between aggressive and non-aggressive bone tumors

Magnetic resonance imaging in differentiating between aggressive and non-aggressive bone tumors

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Diagnostic Accuracy of Magnetic Resonance Imaging in Diagnosing Bone Tumors Keeping Histopathological Correlation as Gold Standard

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