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

Abstract

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.

Comparison between MRI with spin-echo echo-planar diffusion-weighted sequence (DWI) and histology in the diagnosis of soft-tissue tumours

“…Tuttavia in Letteratura la maggior parte dei lavori sono incentrati sull'effi cacia del DWI nel follow-up post-terapia [5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], in particolare nella premolecules are freer to move (high diffusion coeffi cient) -show a signal loss with increasing b values. Conversely, lesions with a high grade of biological aggressiveness, dizione della risposta dei sarcomi alla chemioterapia, come dimostrano alcuni risultati preliminari [14,15], e nella possibilità di discriminare tra recidiva e necrosi tumorale nello studio dei tumori del sistema muscoloscheletrico, data la frequenza delle recidive post-chirurgiche [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. L'ADC, come già ampiamente dimostrato in altri distretti, è strettamente legato al grado di cellularità del tumore [1,2,22,31].…”

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

“…Whereas DW imaging has been studied in the central nervous system more extensively, there are reports of its use in the evaluation of musculoskeletal tumors, including the characterization of vertebral fractures for the presence of underlying malignancy (24)(25)(26) and the characterization of soft tissue masses as benign or malignant (18,(27)(28)(29)(30)(31)(32). DW imaging has also been used for characterizing changes in the surgical bed in patients examined for evaluation of the possibility of recurrent tumor (23).…”

“…For example, Namimomoto et al (29) showed that leiomyomas could be distinguished from leiomyosarcomas on the basis of ADCs, with an ADC of less than 1 3 10 23 mm 2 /sec as a threshold for defining malignancy, although this work refers to soft-tissue tumors in the gynecologic system. Some authors have studied the differentiation of different histologic features of primary malignant lesions (32) and some have suggested that bone masses showing poor contrast enhancement and prolonged T2 can be evaluated with quantitative DW imaging (27). Caution should be exercised, however, when using DW imaging for characterization, because an overlap in the diffusion properties has been identified within benign and malignant soft-tissue tumors (18) and in particular, benign and malignant myxoid lesions (28).…”

Imaging Osteosarcoma

“…Both CO and CS showed a similar enhancement pattern; both showed septonodular and peripheral rim enhancement. The authors found DWI more useful for differentiating between CO, OS and CS or other types of osteosarcoma than Gd-enhanced MRI [38].…”

“…Yakushiji et al found diffusion weighted MRI (DWI) more reliable than DCE MRI in differentiating between chondroblastic osteosarcoma and chondrosarcoma or other types of osteosarcoma [38].…”