Document Detail


Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging.
MedLine Citation:
PMID:  20392983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To validate a technique for reproducible measurement of the osteochondroma cartilage cap with computed tomography (CT) and magnetic resonance (MR) imaging and to reevaluate the correlation of the thickness of the cartilage cap with pathologic findings to improve noninvasive differentiation of benign osteochondromas from secondary chondrosarcomas.
MATERIALS AND METHODS: The institutional review board approved the study and waived the need for informed consent. HIPAA compliance was maintained. After validation of the measurement technique, 101 pathologically confirmed osteochondromas were retrospectively reviewed. Patient demographic data, histologic diagnosis, and chondrosarcoma grade were recorded. Two musculoskeletal radiologists used a standardized technique to independently measure the thicknesses of the cartilage caps on CT and MR images; these measurements were compared for interobserver agreement. Agreement between measurements with CT and MR imaging was also evaluated, as were the sensitivity and specificity of both modalities for differentiation of osteochondromas from chondrosarcomas.
RESULTS: Evaluated were 67 benign osteochondromas (from 49 male patients and 18 female patients; mean age, 23.4 years) and 34 secondary chondrosarcomas (from 27 male patients and seven female patients; mean age, 33.2 years). On the basis of the proposed measuring technique, there was 88% interobserver measurement agreement with MR imaging (95% confidence interval [CI]: 80%, 94%) and 93% with CT (95% CI: 84%, 98%). The median difference between measurements of cap thickness at CT and MR imaging was 0 cm (25th and 75th percentiles, -3 mm and 1 mm, respectively). With 2 cm used as a cutoff for distinguishing benign osteochondromas from chondrosarcomas, the sensitivities and specificities were 100% and 98% for MR imaging and 100% and 95% for CT, respectively.
CONCLUSION: The proposed measuring technique allows accurate and reproducible measurement of cartilage cap thickness with both CT and MR imaging. Cap thickness of 2 cm or greater strongly indicated secondary chondrosarcomas.
Authors:
Stephanie A Bernard; Mark D Murphey; Donald J Flemming; Mark J Kransdorf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2010-04-14
Journal Detail:
Title:  Radiology     Volume:  255     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-07-15     Revised Date:  2010-12-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  857-65     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2010
Affiliation:
Department of Radiology, Penn State-Milton S. Hershey Medical Center, 500 University Dr, Room H066, Hershey, PA 17033, USA. sbernard@hmc.psu.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Neoplasms / diagnosis*,  pathology,  radiography
Cartilage / pathology*
Child
Child, Preschool
Diagnosis, Differential
Exostoses, Multiple Hereditary / diagnosis*,  pathology,  radiography
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Osteochondroma / diagnosis*,  pathology,  radiography
Reproducibility of Results
Retrospective Studies
Statistics, Nonparametric
Tomography, X-Ray Computed / methods*
Comments/Corrections
Comment In:
Radiology. 2010 Dec;257(3):896; author reply 896-7   [PMID:  21084423 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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