Published in:
01-11-2013 | Musculoskeletal
Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma
Published in: European Radiology | Issue 11/2013
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Objectives
To determine whether dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can differentiate benign from malignant cartilage tumours compared to standard MRI. To investigate whether a cutoff value could be determined to differentiate enchondroma from low-grade chondrosarcoma (CS) more accurately.
Methods
One hundred six patients were included in this retrospective study: 75 with enchondromas (mean age = 41 years) and 31 with CS (mean age = 47 years). Within this population, a subgroup of patients was selected with the tumour arising in a long bone. At the time of diagnosis, the tumours were evaluated on MRI, including standard MRI, DCE-MRI, and region-of-interest (ROI) analysis to obtain information on tumour vascularisation and perfusion.
Results
The main cutoff value to differentiate enchondroma from CS contained a two-fold more relative enhancement compared with muscle, combined with a 4.5 (= 76°) slope value, with 100 % sensitivity and 63.3 % specificity. The prediction of CS diagnosis with DCE-MRI had 93.4 % accuracy. The accuracy of the standard MRI parameters was equal to the DCE-MRI parameters.
Conclusions
Standard MRI and DCE-MRI both play an important and complementary role in differentiating enchondroma from low-grade CS. A combination of both imaging techniques leads to the highest diagnostic accuracy for differentiating cartilaginous tumours.
Key Points
• DCE-MRI plays an important role in differentiating benign from malignant cartilage tumours.
• Retrospective study defined a threshold for 100 % detection of chondrosarcoma with DCE-MRI.
• The threshold values were relative enhancement = 2 and slope = 4.5.
• One hundred per cent chondrosarcoma detection corresponds with 36.7 % false-positive diagnosis of enchondroma.
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Standard MRI is complementary to DCE-MRI in differentiating cartilaginous tumours.