Computed direct magnification radiography of bone tumors

The purpose of this study was to assess the diagnostic performance of computed direct magnification radiography in diagnosing bone tumors as compared with conventional radiography. Ninety-one patients with primary bone tumors and tumor-like lesions were radiographed with conventional and magnification techniques. All radiographs were analyzed by one orthopedic surgeon and two radiologists and the findings were correlated with histopathology. Two microfocal X-ray units were used for computed direct magnification radiography with a focal spot size of 20-130 microm. Using magnification versus conventional radiography, the diagnosis of benign and malignant lesions as well as the individual tumor diagnosis was obtained with higher accuracy (85% versus 71% and 69% versus 51%, respectively, P<0.01). Margins of destruction, periosteal reactions, and matrix patterns were evaluated with higher accuracy by all observers (P<0.01). We conclude that computed direct magnification radiography may improve evaluation and diagnosis of bone tumors.