Skip to main content

Advertisement

SpringerLink
Log in

Correlation of non-mass-like abnormal MR signal intensity with pathological findings surrounding pediatric osteosarcoma and Ewing’s sarcoma

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

The aim of this work was to determine the role of MRI in interpreting abnormal signals within bones and soft tissues adjacent to tumor bulk of osteosarcoma and Ewing’s sarcoma in a pediatric population by correlating MR findings with histopathology.

Materials and methods

Thirty patients met the inclusion criteria, which included (1) osteosarcoma or Ewing’s sarcoma, (2) MR studies no more than 2 months prior to surgery, (3) presence of abnormal MR signal surrounding the tumor bulk, (4) pathological material from resected tumor. The patients received standard neoadjuvant chemotherapy. Using grid maps on gross pathology specimens, the abnormal MR areas around the tumor were matched with the corresponding grid sections. Histopathology slides of these sections were then analyzed to determine the nature of the regions of interest. The MR/pathological correlation was evaluated using Mann–Whitney U test and Fisher’s exact test.

Results

Twenty-seven patients had osteosarcoma and three patients had Ewing’s sarcoma. Of the studied areas, 17.4% were positive for tumor (viable or necrotic). There was no statistically significant correlation between areas positive for tumor and age, gender, signal extent and intensity on MRI, or tissue type. There was, however, a statistically significant correlation between presence of tumor and the appearance of abnormal soft tissue signals. A feathery appearance correlated with tumor-negative areas whereas a bulky appearance correlated with tumor-positive regions.

Conclusions

MR imaging is helpful in identifying the nature of abnormal signal areas surrounding bone sarcomas that are more likely to be tumor-free, particularly when the signal in the soft tissues surrounding the tumor is feathery and edema-like in appearance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Herzog CE. Overview of sarcomas in the adolescent and young adult population. J Pediatr Hematol Oncol. 2005;27(4):215–8.

    Article  PubMed  Google Scholar 

  2. Caudill JS, Arndt CA. Diagnosis and management of bone malignancy in adolescence. Adolesc Med State Art Rev. 2007;18(1):62–78. ix.

    PubMed  Google Scholar 

  3. Longhi A, Errani C, De Paolis M, et al. Primary bone osteosarcoma in the pediatric age: state of the art. Cancer Treat Rev. 2006;32:423–36.

    Article  PubMed  Google Scholar 

  4. Seeger LL, Widoff BE, Bassett LW, et al. Preoperative evaluation of osteosarcoma: Value of gadopentate dimeglumine-enhanced MR imaging. AJR. 1991;157:347–51.

    PubMed  CAS  Google Scholar 

  5. Onikul E, Fletcher BD, Parham DM, et al. Accuracy of MR imaging for estimating intraosseous extent of osteosarcoma. AJR. 1996;167:1211–5.

    PubMed  CAS  Google Scholar 

  6. Sundaram M, McGuire MH, Herbold DR, Wolverson MK, Heiberg E, et al. Magnetic resonance imaging in planning limb-salvage surgery for primary malignant tumors of bone. J Bone Joint Surg Am. 1986;68:809–19.

    PubMed  CAS  Google Scholar 

  7. Brisse H, Ollivier L, Edeline V, et al. Imaging of malignant tumours of the long bones in children: monitoring response to neoadjuvant chemotherapy and preoperative assessment. Pediatr Radiol. 2004;34:595–605.

    Article  PubMed  Google Scholar 

  8. Kaste SC. Imaging pediatric bone sarcomas. Radiol Clin North Am. 2011;49(4):749–65. vi-vii.

    Article  PubMed  Google Scholar 

  9. Panuel M, Gentet JC, Scheiner C, et al. Physeal and epiphyseal extent of primary malignant bone tumors in childhood. Correlation of preoperative MRI and the pathologic examination. Pediatr Radiol. 1993;23(6):421–4.

    Article  PubMed  CAS  Google Scholar 

  10. Schima W, Amann G, Stiglbauer R, et al. Preoperative staging of osteosarcoma: efficacy of MR imaging in detecting joint involvement. Am J Roentgenol. 1994;163(5):1171–5.

    CAS  Google Scholar 

  11. Hoffer FA, Nikanorov AY, Reddick WE, et al. Accuracy of MR imaging for detecting epiphyseal extension of osteosarcoma. Pediatr Radiol. 2000;30:289–98.

    Article  PubMed  CAS  Google Scholar 

  12. Erlemann R, Reiser MF, Peters PE, et al. Musculoskeletal neoplasms: static and dynamic Gd-DTPA-enhanced MR imaging. Radiology. 1989;171(3):767–73.

    PubMed  CAS  Google Scholar 

  13. Sanchez RB, Quinn SF, Walling A, et al. Musculoskeletal neoplasms after intraarterial chemotherapy: correlation of MR images with pathologic specimens. Radiology. 1990;174(1):237–40.

    PubMed  CAS  Google Scholar 

  14. Lang P, Honda G, Roberts T, et al. Musculoskeletal neoplasm: perineoplastic edema versus tumor on dynamic postcontrast MR images with spatial mapping of instantaneous enhancement rates. Radiology. 1995;197(3):831–9. Erratum in: Radiology 1996;198(3):910–911.

    PubMed  CAS  Google Scholar 

  15. Beltran J, Simon DC, Katz W, et al. Increased MR signal intensity in skeletal muscle adjacent to malignant tumors: pathologic correlation and clinical relevance. Radiology. 1987;162(1 Pt 1):251–5.

    PubMed  CAS  Google Scholar 

  16. Shuman WP, Patten RM, Baron RL, et al. Comparison of STIR and spin-echo MR imaging at 1.5 T in 45 suspected extremity tumors: lesion conspicuity and extent. Radiology. 1991;179(1):247–52.

    PubMed  CAS  Google Scholar 

  17. White LM, Wunder JS, Bell RS, et al. Histologic assessment of peritumoral edema in soft tissue sarcoma. Int J Radiat Oncol Biol Phys. 2005;61(5):1439–45.

    Article  PubMed  Google Scholar 

  18. Lawrence JA, Babyn PS, Chan HS, et al. Extremity osteosarcoma in childhood: prognostic value of radiologic imaging. Radiology. 1993;189:43–7.

    PubMed  CAS  Google Scholar 

  19. McDonald DJ. Limb-salvage surgery for treatment of sarcomas of the extremities. AJR. 1994;163(3):509–13.

    PubMed  CAS  Google Scholar 

  20. James SL, Panicek DM, Davies AM. Bone marrow oedema associated with benign and malignant bone tumours. Eur J Radiol. 2008;67(1):11–21.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank The Board of Trustees of the Children’s Cancer Center of Lebanon Foundation and the International Outreach Program at the St. Jude Children’s Research Hospital, Memphis, TN, USA, for their continuous support. The authors would also like to thank Dr. Monique Chaaya (Chair, Department of Epidemiology & Population Health, American University of Beirut, Beirut, Lebanon) for her assistance in statistical analysis.

Author information

Authors and Affiliations

  1. Department of Surgery, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon

    Karim Z. Masrouha, Rachid Haidar & Said Saghieh

  2. Internal Medicine Division of Hematology & Oncology, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon

    Khaled M. Musallam

  3. Pathology, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon

    Alexis Bou Samra, Ayman Tawil & Zaher Chakhachiro

  4. Children’s Cancer Center of Lebanon, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon

    Raya Saab, Samar Muwakkit & Miguel R. Abboud

  5. Diagnostic Radiology, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon

    Abeer Abdallah & Nabil J. Khoury

Authors
  1. Karim Z. Masrouha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Khaled M. Musallam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexis Bou Samra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayman Tawil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rachid Haidar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zaher Chakhachiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Said Saghieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Abeer Abdallah
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Raya Saab
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Samar Muwakkit
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Miguel R. Abboud
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Nabil J. Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nabil J. Khoury.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Masrouha, K.Z., Musallam, K.M., Samra, A.B. et al. Correlation of non-mass-like abnormal MR signal intensity with pathological findings surrounding pediatric osteosarcoma and Ewing’s sarcoma. Skeletal Radiol 41, 1453–1461 (2012). https://doi.org/10.1007/s00256-012-1383-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1383-8

Keywords

Search

Navigation