Clinical Significance of MRI and Pathological Features of Giant Cell Tumor of Bone Boundary

Abstract

Objective To find new clues to reduce postoperative recurrence after intralesional curettage by studying MRI and pathological features of giant tumor of bone (GCTB) boundaries. Methods A retrospective study was performed in the departments of orthopaedic surgery and medical imaging at our hospitals from January 2006 to August 2016. A total of 16 GCTB patients confirmed by pathology were asked to participate in the present study. The age range was from 18 to 44 years (9 women and 7 men). All patients underwent MRI examination. All patients underwent en bloc resection and complete postoperative tumor segments were obtained. Five specimens were obtained randomly at the place of the segments where the GCTB boundary showed different types on MRI. Ordinary HE staining was used for all specimens and we measured the depth of local tumor cell infiltration (240 measurements). Results were expressed as means ± standard deviation. Statistical analyses were carried out with one‐way ANOVA and the Student–Newman–Keuls test. P < 0.05 was considered statistically significant. The kappa test was used to analyze the degree of agreement of observers. Results A total of 16 patients (median age 30.56 years; range, 18–44 years) with GCTB (the number of distal femurs and proximal tibias was 9 and 7, respectively) were tested. The boundaries of all GCTB cases were composed of clear boundary, relatively clear boundary, and blurred boundary in different proportions on MRI. Based on continuous observation of all MRI, all boundaries were incomplete. The kappa value between two radiologists and two pathologists was 0.91 and 0.88, respectively. The average depth of local tumor cell infiltration in the clear boundary, relatively clear boundary, and blurred boundary groups was 0.42 ± 0.11 mm, 2.85 ± 0.21 mm, and 4.83 ± 0.12 mm, respectively. There was statistical difference among the three groups ( F = 17.62, P < 0.05). There was also statistical difference between each of the two groups ( q ‐value was 8.95, 14.28, and 5.21, respectively, P < 0.05). The depth of local tumor cell infiltration with blurred boundaries on MRI was the largest and the depth with clear boundaries was the smallest. Conclusion The intralesional curettage boundaries need to be expanded on the basis of different types of boundaries provided by MRI.

Characteristics of primary giant cell tumor in soft tissue on magnetic resonance imaging: A case report

“…In our study, the lesion showed a non-homogeneous hypo-intensity to iso-intensity on T1WI and hyper-intensity on T2WI. Consistent with previous reports, MR images of bone GCT may suggest the presence of solid components with hypo-intensity to iso-intensity on T1WI and T2WI, caused by hemosiderin deposition or high collagen content[ 3 , 4 ]. On contrast-enhanced images, unlike malignant soft tissue tumors or GCT-ST tumors with diffuse cystic components located in the subcutaneous tissue[ 8 - 11 ], the solid region of the lesion was slowly enhanced like hypervascular tissue, in line with IHC performance such as in bone GCT and the findings in other benign soft tissue tumors[ 2 - 4 ].…”

A Multiparametric Method Based on Clinical and CT-Based Radiomics to Predict the Expression of p53 and VEGF in Patients With Spinal Giant Cell Tumor of Bone

“…Imaging has always been an important examination for preoperative tumor evaluation, but most of the previous studies on GCTB focused on tumors of the extremities (53)(54)(55)(56), which led to many findings of indicators not applicable to the spinal tumors, such as the distance between the edge of the tumor and joint surface, "paintbrush borders" sign, destruction of posterior cortical bone, and depth of local tumor cell infiltration. Although the majority of GCTB lesions are located in the metaphysis and epiphyses of the long tubular bones, approximately one-third of tumors are located in the axial skeleton.…”

Cross‐Sectional Area Measurement Techniques of Soft Tissue: A Literature Review

“…Magnetic resonance imaging provides great contrast between tissues and there is no pressure applied on the tissue. Image plane orientation can be set accurately, and with 3-D sequences, the imaging plane can be adjusted postimaging (re-slicing) 63,107 . However, how well the contrast in the MRI image corresponds with the actual borders of the tendon remains unknown, and, as a result, the MRI-based measurement may either underestimate or overestimate the tendon CSA.…”