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The clinical value of combined use of MR imaging and multi-slice spiral CT in limb salvage surgery for orthopaedic oncology patients: initial experience in nine patients.

Xu J, Shen J, Ding Y, Shen HY, Zeng ZP, Ma RF, Li CH, Barden B - Radiol Oncol (2012)

Bottom Line: Preoperative planning including determination of the osteotomy plane and diameters of the prosthesis was performed basing on the preoperative CT and MR images.An excellent functional outcome was achieved in all patients.In the present study, MRI was found to be superior to CT for determining the tumour extension, combined use of MRI and CT measurement provided high precision for the fit of the prosthesis and excellent functional results.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiangxi Road, 510120, Guangzhou, P. R. China.

ABSTRACT

Background: The purpose of this prospective study was to evaluate the value of the combined use of MR imaging and multi-slice spiral CT for limb salvage surgery in orthopaedic oncology patients.

Patients and methods: Nine consecutive patients with lower/upper limb malignant bone tumours (7 osteosarcomas and 2 chondrosarcomas) were treated with limb-salvaging procedures. Preoperative planning including determination of the osteotomy plane and diameters of the prosthesis was performed basing on the preoperative CT and MR images. The histopathology was performed as golden diagnostic criteria to evaluate the accuracy of CT and MR-based determination for tumour's boundary.

Results: The tumour extension measured on MRI was consistent with the actual extension (P>0.05, paired Student's t test), while the extension measured on CT imaging was less than the actual extension. The length, offset and alignment of the affected limb were reconstructed accurately after the operation. An excellent functional outcome was achieved in all patients.

Conclusions: In the present study, MRI was found to be superior to CT for determining the tumour extension, combined use of MRI and CT measurement provided high precision for the fit of the prosthesis and excellent functional results.

No MeSH data available.


Related in: MedlinePlus

CT and MRI determining of tumour extension. A female, 19-year-old patient with osteosarcoma in the distal femur. Coronal MPR image (1), volume rendering CT image (2), coronal enhanced T1-weighted image (3) and fat-suppressed T2-weighted image (4) showed the tumour in the proximal femur. Distance from the gap of the knee to the tumour margin in orthogonal coronal CT image and on orthogonal coronal T2-weigthed image was respectively 7.2 cm and 8.4 cm. The boundary of tumour as determined by MRI and CT were shown in line c and f respectively. Line i, h, d and b were the plane 1cm, 2cm around tumour and 1cm, 2cm to the normal tissue as determined by CT respectively. Line g, e and a were the plane 1cm, 2cm around tumour and 1cm to the normal tissue as determined by MRI. A–J are corresponding histologic images (HE, ×200) of line a–j. No tumour cells were found on the plane a, b, c (Figures A, B, C).
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f2-rado-46-03-189: CT and MRI determining of tumour extension. A female, 19-year-old patient with osteosarcoma in the distal femur. Coronal MPR image (1), volume rendering CT image (2), coronal enhanced T1-weighted image (3) and fat-suppressed T2-weighted image (4) showed the tumour in the proximal femur. Distance from the gap of the knee to the tumour margin in orthogonal coronal CT image and on orthogonal coronal T2-weigthed image was respectively 7.2 cm and 8.4 cm. The boundary of tumour as determined by MRI and CT were shown in line c and f respectively. Line i, h, d and b were the plane 1cm, 2cm around tumour and 1cm, 2cm to the normal tissue as determined by CT respectively. Line g, e and a were the plane 1cm, 2cm around tumour and 1cm to the normal tissue as determined by MRI. A–J are corresponding histologic images (HE, ×200) of line a–j. No tumour cells were found on the plane a, b, c (Figures A, B, C).

Mentions: To determine the accuracy of tumour boundary defined by MRT and CT, the specimens were collected from 1cm, 2cm proximal to the tumour plane and 1cm, 2cm distal as determined by MRI and CT and were examined for histopathology (Figure 1,2).


The clinical value of combined use of MR imaging and multi-slice spiral CT in limb salvage surgery for orthopaedic oncology patients: initial experience in nine patients.

Xu J, Shen J, Ding Y, Shen HY, Zeng ZP, Ma RF, Li CH, Barden B - Radiol Oncol (2012)

CT and MRI determining of tumour extension. A female, 19-year-old patient with osteosarcoma in the distal femur. Coronal MPR image (1), volume rendering CT image (2), coronal enhanced T1-weighted image (3) and fat-suppressed T2-weighted image (4) showed the tumour in the proximal femur. Distance from the gap of the knee to the tumour margin in orthogonal coronal CT image and on orthogonal coronal T2-weigthed image was respectively 7.2 cm and 8.4 cm. The boundary of tumour as determined by MRI and CT were shown in line c and f respectively. Line i, h, d and b were the plane 1cm, 2cm around tumour and 1cm, 2cm to the normal tissue as determined by CT respectively. Line g, e and a were the plane 1cm, 2cm around tumour and 1cm to the normal tissue as determined by MRI. A–J are corresponding histologic images (HE, ×200) of line a–j. No tumour cells were found on the plane a, b, c (Figures A, B, C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472943&req=5

f2-rado-46-03-189: CT and MRI determining of tumour extension. A female, 19-year-old patient with osteosarcoma in the distal femur. Coronal MPR image (1), volume rendering CT image (2), coronal enhanced T1-weighted image (3) and fat-suppressed T2-weighted image (4) showed the tumour in the proximal femur. Distance from the gap of the knee to the tumour margin in orthogonal coronal CT image and on orthogonal coronal T2-weigthed image was respectively 7.2 cm and 8.4 cm. The boundary of tumour as determined by MRI and CT were shown in line c and f respectively. Line i, h, d and b were the plane 1cm, 2cm around tumour and 1cm, 2cm to the normal tissue as determined by CT respectively. Line g, e and a were the plane 1cm, 2cm around tumour and 1cm to the normal tissue as determined by MRI. A–J are corresponding histologic images (HE, ×200) of line a–j. No tumour cells were found on the plane a, b, c (Figures A, B, C).
Mentions: To determine the accuracy of tumour boundary defined by MRT and CT, the specimens were collected from 1cm, 2cm proximal to the tumour plane and 1cm, 2cm distal as determined by MRI and CT and were examined for histopathology (Figure 1,2).

Bottom Line: Preoperative planning including determination of the osteotomy plane and diameters of the prosthesis was performed basing on the preoperative CT and MR images.An excellent functional outcome was achieved in all patients.In the present study, MRI was found to be superior to CT for determining the tumour extension, combined use of MRI and CT measurement provided high precision for the fit of the prosthesis and excellent functional results.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiangxi Road, 510120, Guangzhou, P. R. China.

ABSTRACT

Background: The purpose of this prospective study was to evaluate the value of the combined use of MR imaging and multi-slice spiral CT for limb salvage surgery in orthopaedic oncology patients.

Patients and methods: Nine consecutive patients with lower/upper limb malignant bone tumours (7 osteosarcomas and 2 chondrosarcomas) were treated with limb-salvaging procedures. Preoperative planning including determination of the osteotomy plane and diameters of the prosthesis was performed basing on the preoperative CT and MR images. The histopathology was performed as golden diagnostic criteria to evaluate the accuracy of CT and MR-based determination for tumour's boundary.

Results: The tumour extension measured on MRI was consistent with the actual extension (P>0.05, paired Student's t test), while the extension measured on CT imaging was less than the actual extension. The length, offset and alignment of the affected limb were reconstructed accurately after the operation. An excellent functional outcome was achieved in all patients.

Conclusions: In the present study, MRI was found to be superior to CT for determining the tumour extension, combined use of MRI and CT measurement provided high precision for the fit of the prosthesis and excellent functional results.

No MeSH data available.


Related in: MedlinePlus