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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Research article

Imaging algorithm and multimodality evaluation of spinal osteoblastoma

Authors: Zihuan Huang, Tingsong Fang, Zhiguang Si, Youcai Li, Lan Zhang, Chunling Zheng, Shenmei Li, Manting Su, Xiaomin Liu, Xiaodan Li, Yuankui Wu

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

To analyze the features of CT, MRI and PET/CT and their diagnostic value for spinal osteoblastomas (OBs).

Methods

The radiological and clinical data of 21 patients with histopathologically-confirmed spinal OBs were analyzed retrospectively.

Results

Sixteen of the 21 cases were benign and 5 were aggressive OBs. Tumors were located in the lumbar (n = 11), cervical (n = 4), thoracic (n = 5), and sacral (n = 1) spinal regions. Nineteen cases were centered in the posterior elements of the spine, 13 of which extended into the vertebral body. Punctate or nodular calcifications were found in all cases on CT with a complete sclerotic rim (n = 12) or incomplete sclerotic rim (n = 8). The flare phenomenon (indicative of surrounding tissue inflammation) was found in 17/21 cases on CT, thin in 11 cases and thick in 6 cases, and in 19/19 cases on MRI, thin in 1 case and thick in 18 cases. On 18F-FDG PET/CT, all cases (8/8) were metabolically active with the SUVmax of 12.3–16.0; the flare sign was observed in 8 cases, including 7 cases of hypometabolism and 1 case of coexistence of hypermetabolism and hypometabolism. Based on CT, 3, 12, and 6 cases were classified as Enneking stage 1, 2 and 3, respectively. Of 19 cases with MRI, 1 and 18 cases were classified as Enneking stage 2 and 3, respectively.

Conclusions

Spinal OB has multiple unique characteristic radiological features. Although a larger sample size is needed, combining CT, MRI and PET may be beneficial to optimize preoperative diagnosis and care of patients with OBs.
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Metadata
Title
Imaging algorithm and multimodality evaluation of spinal osteoblastoma
Authors
Zihuan Huang
Tingsong Fang
Zhiguang Si
Youcai Li
Lan Zhang
Chunling Zheng
Shenmei Li
Manting Su
Xiaomin Liu
Xiaodan Li
Yuankui Wu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03252-y

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