Tumors and Tumor-Like Lesions of Bone: Imaging and Pathology of Specific Lesions

Resnick, Donald; Kyriakos, Michael; Greenway, Guerdon

doi:10.1016/b0-7216-0270-3/50073-6

Cited by 166 publications

(259 citation statements)

References 147 publications

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“…1d inset). As mentioned above, such a sign is not specific, occurring in a number of other diseases including the sequestrum of osteomyelitis [12], chronic abscesses, osteogenic sarcoma and hemangioma [13], and malignant bone metastasis [14].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the diagnosis of BS is made by finding just "hot" uptake, and CR and CT diagnosis relies upon finding a lucent or mineralized nidus. As is well known, however, such a sign may also occur in the sequestrum of osteomyelitis [12], abscess, osteogenic sarcoma and hemangioma [13], and even malignant metastasis [14]. Thus, detection of the FVZ is considered to be essential for more precise diagnosis of OO.…”

Section: Introductionmentioning

confidence: 99%

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Depiction of Nidi and Fibrovascular Zones of Osteoid Osteomas Using Gamma-Correction Tc-99m HDP Pinhole Bone Scan and Conventional Radiograph, and Correlation with CT, MRI, and PVC Phantom Imaging

Bahk

Kim

Chung

et al. 2011

Nucl Med Mol Imaging

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Purpose For the precise imaging diagnosis of osteoid osteoma (OO), the identification of the nidus and fibrovascular zone (FVZ) is essential. However, the latter sign has received little attention because it is difficult to demonstrate. We applied the recently introduced gamma correction (GC) to depict the FVZ on pinhole bone scan (PBS), conventional radiography (CR), and computed tomography (CT). Nongamma correction MRI was also analyzed for reference. Methods Ten patients with histologically proven diagnoses of OO were enrolled in this retrospective study. PBS, CR, and CT were processed by GC to demonstrate the nidi and FVZ as distinct yet integrating components of OO. PBS was performed using a 4-mm pinhole collimator 3 h after iv injection of 925 to 1,110 MBq (25 to 30 mCi) of Tc-99m HDP, and anteroposterior and mediolateral CR and transverse CT were taken according to the standard technique. MRI sequences included T1-and T2-weighted images. For gamma correction, we utilized the Photo Correction Wizard program of ACD Photo Editor v3.1. A team of three qualified nuclear physician-radiologists, two nuclear physicians, and one MRI specialist read bone scans, radiographs, and MRIs of OO according to each specialty, and orthopaedic aspects and histology were reviewed by one qualified orthopedic surgeon and two qualified pathologists, respectively. Each observer first read the images separately with basic information about the aim of the study given and then in concert. Interpretive disagreement was settled by discussion and consensus. Results On pinhole scan, nidi were presented as areas of intense tracer uptake in all cases, and, importantly after GC, a thin ring-like zone with lower tracer uptake became visible in seven out of ten cases. GCCR also revealed a thin lucent zone Imaging (2011) 45:21-29 DOI 10.1007 that circumscribed the nidi in six out of ten cases and GCCT in two of four cases. MRI, without GC, presented nidi with high signal in the center and a thin ring-like zone with low signal in the periphery in five out of six cases. Ring-like zones were 1-2 mm in thickness and circumscribed the nidus as an integrated part and, hence, were morphologically interpreted as FVZ. Histologically, the presence of a variously mineralized FVZ was confirmed in four cases, but individual locusby-locus image-histology correlation could not be accompolished because specimens were fragmentary. In the FVZ, tracer uptake was lower than in nidi, presumably reflecting that bone metabolism in the two parts differs as in their histology. Statistically, no significant correlation existed between the duration of symptoms and imaging demonstrability of the FVZ (Spearman's test r=−0.057, p=0.877), but parallelism existed in the demonstrability of the FVZ among GC PBS, CR, and CT, and non-correction MRI. Conclusions GC was useful to enhance the resolution of PBS, CR, and CT in OO so that both the nidi and FVZ were separately imaged. The use of CG PBS and CR in combination is recommended for the specific diagnosis of OO with...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Depiction of Nidi and Fibrovascular Zones of Osteoid Osteomas Using Gamma-Correction Tc-99m HDP Pinhole Bone Scan and Conventional Radiograph, and Correlation with CT, MRI, and PVC Phantom Imaging

Bahk

Kim

Chung

et al. 2011

Nucl Med Mol Imaging

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“…[8][9][10] Osteoid osteoma in the hand region is very difficult to diagnose, which is mostly characterized by persistent local pain. [5,11] Diagnosis can generally be established by clinical and radiological findings. Swelling, localized tenderness, and nocturnally aggravating pain contribute to clinical picture.…”

Section: Discussionmentioning

confidence: 99%

“…[4] Osteoid osteoma was reported to be typically a radiolucent lesion developed by intracortical, periosteal, and endosteal bone formation with or without calcification. [5] Osteoid osteoma is rarely seen at hand and wrist region, which was reported to be 6-13%. The commonly affected bones in the order of On altı yaşındaki bayan olgumuz beşinci metakarp üzerinde yaklaşık bir senedir geceleri artan, salisilatlara cevap veren ağrı şikayeti ile polikliniğimize başvurdu.…”

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confidence: 99%