Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard.
Clin Radiol
; 74(9): 736.e13-736.e21, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-31255248
ABSTRACT
AIM:
To evaluate the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing the resection margins of primary malignant bone tumours. MATERIALS ANDMETHODS:
Resected primary malignant bone tumour specimens removed from 46 patients (27 male; mean age 48±22 years) were imaged using MRI (fat-saturated proton density-weighted and three-dimensional fat-suppressed T1-weighted gradient-recalled-echo) and CT immediately after surgery. A radiologist and an orthopaedist evaluated bone and soft-tissue margins of the specimens on both examinations. Histological evaluation was performed by a senior orthopaedic oncology pathologist. Margins were classified as R0 (safe margins), R1 (residuals between 0 and 1 mm), and R2 (macroscopic residuals). Cohen's k, chi-square, and McNemar's statistics were used.RESULTS:
Having histology as the reference standard, reproducibility of the radiologist ranged from moderate (k=0.544) to substantial (k=0.741) for bone and soft-tissue margins on CT, respectively, while that of the orthopaedist ranged from fair (k=0.316) to moderate (k=0.548). When comparing R2 and R0+R1 scores, reproducibility of readers' evaluation of bone margins increased ranging from substantial (k=0.655) to perfect (k=1.000). Inter-reader agreement ranged from fair (k=0.308) to substantial (k=0.633). Accuracy of the radiologist and orthopaedist ranged from 76% to 83% and from 68% to 72%, respectively. When comparing R2 and R0+R1 scores, the accuracy of both readers ranged from 83% to 100%. There was no association between local recurrence and margin scores of histology, MRI, and CT (p≥0.058).CONCLUSIONS:
MRI and CT may be useful for extemporaneous analysis of resection margins of primary malignant bone tumours, although wide accuracy variability between the different imaging methods was observed.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ósseas
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Imageamento por Ressonância Magnética
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Tomografia Computadorizada por Raios X
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Margens de Excisão
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Radiol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália