Correlation between post-chemotherapy MRI and histopathology of malignant bone tumors treated with extra-articular resection.
Extra-articular resection
Joint involvement
MRI
Pediatric osteosarcoma
Journal
Skeletal radiology
ISSN: 1432-2161
Titre abrégé: Skeletal Radiol
Pays: Germany
ID NLM: 7701953
Informations de publication
Date de publication:
30 Sep 2024
30 Sep 2024
Historique:
received:
28
03
2024
accepted:
20
09
2024
revised:
19
09
2024
medline:
30
9
2024
pubmed:
30
9
2024
entrez:
30
9
2024
Statut:
aheadofprint
Résumé
Magnetic resonance imaging (MRI) remains the gold standard for diagnosing tumoral joint involvement; however, its interpretation remains uncertain due to the presence of perilesional edema that can lead to unjustified arthrectomy. The aim of the study is to identify precise MRI signs that are predictive of joint involvement. This retrospective multicenter study included 25 patients who underwent extra-articular resection for malignant bone tumor with suspected joint involvement at the shoulder, hip, or knee, between January 2004 and July 2023. Joint resection was indicated based on preoperative MRI examination. MRI signs of joint involvement were joint effusion, capsuloligamentous invasion, disruption of articular cartilage, and intra-articular tumor mass. We then compared histopathological "true" joint involvement of the resected specimen with its preoperative MRI diagnosis. Extra-articular resection was performed in 9 shoulders, 4 hips, and 12 knees. Histological analysis confirmed wide resections for all patients. Based on histopathological analysis, extra-articular resection was unjustified in 40% (44%, 0%, and 50%, respectively). The most specific iconographic criteria were intra-capsular cortical breach and the presence of a tumor mass inside the joint. Articular cartilage disruption is often the most accurate sign. Our results suggest that MRI has a poor ability to accurately diagnose joint involvement. To date, however, this is the best tool available. In addition to obvious signs of joint involvement, MRI analysis must be performed with a thorough understanding of capsular anatomy and its particularities for each joint so as not to miss other signs, such as intra-capsular cortical effraction.
Identifiants
pubmed: 39347860
doi: 10.1007/s00256-024-04806-0
pii: 10.1007/s00256-024-04806-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to International Skeletal Society (ISS).
Références
Williams RF, Fernandez-Pineda I, Gosain A. Pediatric sarcomas. Surg Clin North Am. 2016;96:1107–25.
doi: 10.1016/j.suc.2016.05.012
pubmed: 27542645
Golfieri R, Baddeley H, Pringle JS, Leung AWL, Greco A, Souhami R, et al. Primary bone tumors. Acta Radiol. 1991;32:290–8.
doi: 10.1177/028418519103200405
pubmed: 1650569
Abed R, Grimer R. Surgical modalities in the treatment of bone sarcoma in children. Cancer Treat Rev. 2010;36:342–7.
doi: 10.1016/j.ctrv.2010.02.010
pubmed: 20223595
Grimer RJ. Surgical options for children with osteosarcoma. Lancet Oncol. 2005;6:85–92.
doi: 10.1016/S1470-2045(05)01734-1
pubmed: 15683817
Journeau P, Dautel G, Lascombes P. Prise en charge chirurgicale des tumeurs osseuses chez l’enfant. Ann Fr Anesth Réanimation. 2006;25:432–9.
doi: 10.1016/j.annfar.2005.10.018
Bacci G, Ferrari S, Lari S, Mercuri M, Donati D, Longhi A, et al. Amputation or limb salvage in patients treated by neoadjuvant chemotherapy. J Bone Jt Surg. 2002;84:5.
doi: 10.1302/0301-620X.84B1.0840088
Golfieri R, Baddeley H, Pringle JS, Souhami R. The role of the STIR sequence in magnetic resonance imaging examination of bone tumours. Br J Radiol. 1990;63:251–6.
doi: 10.1259/0007-1285-63-748-251
pubmed: 2346863
Kaste SC. Imaging pediatric bone sarcomas. Radiol Clin North Am. 2011;49:749–65.
doi: 10.1016/j.rcl.2011.05.006
pubmed: 21807172
Schima W, Amann G, Stiglbauer R, Windhager R, Kramer J, Nicolakis M, et al. Preoperative staging of osteosarcoma: efficacy of MR imaging in detecting joint involvement. Am J Roentgenol. 1994;163:1171–5.
doi: 10.2214/ajr.163.5.7976895
Thompson MJ, Shapton JC, Punt SE, Johnson CN, Conrad EU. MRI identification of the osseous extent of pediatric bone sarcomas. Clin Orthop. 2018;476:559–64.
doi: 10.1007/s11999.0000000000000068
pubmed: 29529641
Quan GMY, Slavin JL, Schlicht SM, Smith PJ, Powell GJ, Choong PFM. Osteosarcoma near joints: assessment and implications. J Surg Oncol. 2005;91:159–66.
doi: 10.1002/jso.20268
pubmed: 16118770
Onikul E, Fletcher BD, Parham DM, Chen G. Accuracy of MR imaging for estimating intraosseous extent of osteosarcoma. Am J Roentgenol. 1996;167:1211–5.
doi: 10.2214/ajr.167.5.8911182
Gronemeyer SA, Kauffman WM, Rocha MS, Steen RG, Fletcher BD. Fat-saturated contrast-enhanced T1-weighted MRI in evaluation of osteosarcoma and ewing sarcoma. J Magn Reson Imaging. 1997;7:585–9.
doi: 10.1002/jmri.1880070321
pubmed: 9170046
Rana KA, Meyer J, Ibrahim S, Ralls M, Kent PM. The role of imaging of malignant bone tumors in children and young adults. Curr Probl Cancer. 2013;37:181–91.
doi: 10.1016/j.currproblcancer.2013.07.005
pubmed: 24238583
Bodden J, Neumann J, Rasper M, Fingerle AA, Knebel C, Von Eisenhart-Rothe R, et al. Diagnosis of joint invasion in patients with malignant bone tumors: value and reproducibility of direct and indirect signs on MR imaging. Eur Radiol. 2022;32:4738–48.
doi: 10.1007/s00330-022-08586-w
pubmed: 35258673
Oberlin C, Vacher C, Berthelot J-L. Précis d’anatomie. 11e édition. Editions médicales internationales - Lavoisier (EM Inter); 2004.
Malawer MM, Meller I, Dunham WK. A new surgical classification system for shoulder-girdle resections: analysis of 38 patients. Clin Orthop. 1991;267:33???44.
doi: 10.1097/00003086-199106000-00005
Van Trommel MF, Kroon HM, Bloem JL, Hogendoorn PCW, Taminiau AHM. MR imaging based strategies in limb salvage surgery for osteosarcoma of the distal femur. Skeletal Radiol. 1997;26:636–41.
doi: 10.1007/s002560050302
pubmed: 9428070
Simon MA, Hecht JD. Invasion of joints by primary bone sarcomas in adults. Cancer. 1982;50:1649–55.
doi: 10.1002/1097-0142(19821015)50:8<1649::AID-CNCR2820500832>3.0.CO;2-G
pubmed: 6956428
Chelli Bouaziz M, Riahi H, Mechri M, Abid L, Rafaa M, Ladeb MF. Valeur de l’IRM dans le diagnostic de l’envahissement articulaire par les sarcomes osseux du genou. Bull Cancer (Paris). 2016;103:911–20.
doi: 10.1016/j.bulcan.2016.09.018
pubmed: 27823810
Simon A-L, Hallé A, Tanase A, Peuchmaur M, Jehanno P, Ilharreborde B. Is magnetic resonance imaging reliable for assessing osteosarcoma of the knee joint in children? OTSR. 2021;S1877051721005220.
Malawer MM. Tumors of the shoulder girdle: technique of resection and description of a surgical classification. Orthop Clin North Am. 1991;22:7–35.
doi: 10.1016/S0030-5898(20)31629-1
pubmed: 1992436
Ozaki T, Putzke M, Rödl R, Winkelmann W, Lindner N. Incidence and mechanisms of infiltration of sarcomas in the shoulder. Clin Orthop. 2002;395:209–15.
doi: 10.1097/00003086-200202000-00024
Göbel V, Jürgens H, Etspüler G, Kemperdick H, Jungblut RM, Stienen U, et al. Prognostic significance of tumor volume in localized Ewing’s sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol. 1987;113:187–91.
doi: 10.1007/BF00391442
pubmed: 3558454
Sato K, Miura T, Nakanishi K, Sugiura H. Specific mechanism of the knee joint preventing tumor invasion. Acta Orthop Scand. 1993;64:320–2.
doi: 10.3109/17453679308993635
pubmed: 8322590
Alkalay D, Kollender Y, Mozes M, Meller I. Transarticular tumor invasion via ligamentum teres: a clinical-pathologic study of 12 patients. Acta Orthop Scand. 1998;69:29–30.
doi: 10.3109/17453679809002351
pubmed: 9524513
Ozaki T, Putzke M, Bürger H, Gosheger G, Winkelmann W, Lindner N. Infiltration of sarcomas into the hip joint: comparison of CT, MRI and histologic findings in 67 cases. Acta Orthop Scand. 2002;73:220–6.
doi: 10.1080/000164702753671849
pubmed: 12079023
Saifuddin A. The accuracy of imaging in the local staging of appendicular osteosarcoma. Skeletal Radiol. 2002;31:191–201.
doi: 10.1007/s00256-001-0471-y
pubmed: 11904686
Shahid M, Albergo N, Purvis T, Heron K, Gaston L, Carter S, et al. Management of sarcomas possibly involving the knee joint when to perform extra-articular resection of the knee joint and is it safe? Eur J Surg Oncol EJSO. 2017;43:175–80.
doi: 10.1016/j.ejso.2016.05.018
pubmed: 27266818