Multi-detector computed tomography in evaluating locally aggressive and malignant bone tumours.

Area of Science:

• Radiology
• Oncology
• Orthopedic Surgery

Background:

• Malignant bone tumors require accurate preoperative evaluation for effective treatment planning.
• Multi-Detector Computed Tomography (MDCT) offers advanced imaging capabilities for assessing complex pathologies.

Purpose of the Study:

• To assess the diagnostic accuracy of MDCT in the preoperative evaluation of locally aggressive and malignant bone tumors.
• To correlate MDCT findings with histopathological results for validation.

Main Methods:

• Twenty patients with suspected malignant bone tumors underwent plain radiography followed by MDCT.
• MDCT utilized Multi-Planar Reconstruction (MPR), Volume Rendering (VR), and Maximum Intensity Projection (MIP) techniques.
• Histopathological findings from surgical specimens were compared with MDCT results.

Main Results:

• MDCT demonstrated 92.8% sensitivity and 100% specificity for tumor vascularity and vessel involvement.
• 100% sensitivity and specificity were achieved for detecting cortical breaks, calcification, and periosteal reactions.
• MDCT showed lower sensitivity in identifying joint involvement but provided details on soft tissue extent with contrast enhancement.

Conclusions:

• MDCT is a valuable tool for preoperative assessment of malignant bone tumors, particularly for evaluating cortical integrity, calcification, periosteal reaction, and vascularity.
• While MRI is preferred for soft tissue and marrow assessment, MDCT serves as a viable alternative due to faster acquisition and better resolution, especially when MRI is unavailable.
• Advanced 3D techniques like MPR, VR, and MIP enhance the visualization of tumor extent and relationship with adjacent structures.