Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard

L. Cannavò, D. Albano, C. Messina, A. Corazza, S. Rapisarda, G. Pozzi, A. Di Bernardo, A. Parafioriti, G. Scotto, G. Perrucchini, A. Luzzati, L. M. Sconfienza

Research output: Contribution to journalArticle

Abstract

AIM: To evaluate the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing the resection margins of primary malignant bone tumours. MATERIALS AND METHODS: Resected primary malignant bone tumour specimens removed from 46 patients (27 male; mean age: 48±22 years) were imaged using MRI (fat-saturated proton density-weighted and three-dimensional fat-suppressed T1-weighted gradient-recalled-echo) and CT immediately after surgery. A radiologist and an orthopaedist evaluated bone and soft-tissue margins of the specimens on both examinations. Histological evaluation was performed by a senior orthopaedic oncology pathologist. Margins were classified as R0 (safe margins), R1 (residuals between 0 and 1 mm), and R2 (macroscopic residuals). Cohen's k, chi-square, and McNemar's statistics were used. RESULTS: Having histology as the reference standard, reproducibility of the radiologist ranged from moderate (k=0.544) to substantial (k=0.741) for bone and soft-tissue margins on CT, respectively, while that of the orthopaedist ranged from fair (k=0.316) to moderate (k=0.548). When comparing R2 and R0+R1 scores, reproducibility of readers' evaluation of bone margins increased ranging from substantial (k=0.655) to perfect (k=1.000). Inter-reader agreement ranged from fair (k=0.308) to substantial (k=0.633). Accuracy of the radiologist and orthopaedist ranged from 76% to 83% and from 68% to 72%, respectively. When comparing R2 and R0+R1 scores, the accuracy of both readers ranged from 83% to 100%. There was no association between local recurrence and margin scores of histology, MRI, and CT (p≥0.058). CONCLUSIONS: MRI and CT may be useful for extemporaneous analysis of resection margins of primary malignant bone tumours, although wide accuracy variability between the different imaging methods was observed.

Original languageEnglish
Pages (from-to)736.e13-736.e21
JournalClinical Radiology
Volume74
Issue number9
DOIs
Publication statusPublished - Sep 1 2019

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Histology
Tomography
Magnetic Resonance Imaging
Bone and Bones
Neoplasms
Fats
Orthopedics
Margins of Excision
Protons
Recurrence
Orthopedic Surgeons
Radiologists

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard. / Cannavò, L.; Albano, D.; Messina, C.; Corazza, A.; Rapisarda, S.; Pozzi, G.; Di Bernardo, A.; Parafioriti, A.; Scotto, G.; Perrucchini, G.; Luzzati, A.; Sconfienza, L. M.

In: Clinical Radiology, Vol. 74, No. 9, 01.09.2019, p. 736.e13-736.e21.

Research output: Contribution to journalArticle

Cannavò, L, Albano, D, Messina, C, Corazza, A, Rapisarda, S, Pozzi, G, Di Bernardo, A, Parafioriti, A, Scotto, G, Perrucchini, G, Luzzati, A & Sconfienza, LM 2019, 'Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard', Clinical Radiology, vol. 74, no. 9, pp. 736.e13-736.e21. https://doi.org/10.1016/j.crad.2019.05.022
Cannavò, L. ; Albano, D. ; Messina, C. ; Corazza, A. ; Rapisarda, S. ; Pozzi, G. ; Di Bernardo, A. ; Parafioriti, A. ; Scotto, G. ; Perrucchini, G. ; Luzzati, A. ; Sconfienza, L. M. / Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard. In: Clinical Radiology. 2019 ; Vol. 74, No. 9. pp. 736.e13-736.e21.
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abstract = "AIM: To evaluate the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing the resection margins of primary malignant bone tumours. MATERIALS AND METHODS: Resected primary malignant bone tumour specimens removed from 46 patients (27 male; mean age: 48±22 years) were imaged using MRI (fat-saturated proton density-weighted and three-dimensional fat-suppressed T1-weighted gradient-recalled-echo) and CT immediately after surgery. A radiologist and an orthopaedist evaluated bone and soft-tissue margins of the specimens on both examinations. Histological evaluation was performed by a senior orthopaedic oncology pathologist. Margins were classified as R0 (safe margins), R1 (residuals between 0 and 1 mm), and R2 (macroscopic residuals). Cohen's k, chi-square, and McNemar's statistics were used. RESULTS: Having histology as the reference standard, reproducibility of the radiologist ranged from moderate (k=0.544) to substantial (k=0.741) for bone and soft-tissue margins on CT, respectively, while that of the orthopaedist ranged from fair (k=0.316) to moderate (k=0.548). When comparing R2 and R0+R1 scores, reproducibility of readers' evaluation of bone margins increased ranging from substantial (k=0.655) to perfect (k=1.000). Inter-reader agreement ranged from fair (k=0.308) to substantial (k=0.633). Accuracy of the radiologist and orthopaedist ranged from 76{\%} to 83{\%} and from 68{\%} to 72{\%}, respectively. When comparing R2 and R0+R1 scores, the accuracy of both readers ranged from 83{\%} to 100{\%}. There was no association between local recurrence and margin scores of histology, MRI, and CT (p≥0.058). CONCLUSIONS: MRI and CT may be useful for extemporaneous analysis of resection margins of primary malignant bone tumours, although wide accuracy variability between the different imaging methods was observed.",
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T1 - Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard

AU - Cannavò, L.

AU - Albano, D.

AU - Messina, C.

AU - Corazza, A.

AU - Rapisarda, S.

AU - Pozzi, G.

AU - Di Bernardo, A.

AU - Parafioriti, A.

AU - Scotto, G.

AU - Perrucchini, G.

AU - Luzzati, A.

AU - Sconfienza, L. M.

PY - 2019/9/1

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N2 - AIM: To evaluate the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing the resection margins of primary malignant bone tumours. MATERIALS AND METHODS: Resected primary malignant bone tumour specimens removed from 46 patients (27 male; mean age: 48±22 years) were imaged using MRI (fat-saturated proton density-weighted and three-dimensional fat-suppressed T1-weighted gradient-recalled-echo) and CT immediately after surgery. A radiologist and an orthopaedist evaluated bone and soft-tissue margins of the specimens on both examinations. Histological evaluation was performed by a senior orthopaedic oncology pathologist. Margins were classified as R0 (safe margins), R1 (residuals between 0 and 1 mm), and R2 (macroscopic residuals). Cohen's k, chi-square, and McNemar's statistics were used. RESULTS: Having histology as the reference standard, reproducibility of the radiologist ranged from moderate (k=0.544) to substantial (k=0.741) for bone and soft-tissue margins on CT, respectively, while that of the orthopaedist ranged from fair (k=0.316) to moderate (k=0.548). When comparing R2 and R0+R1 scores, reproducibility of readers' evaluation of bone margins increased ranging from substantial (k=0.655) to perfect (k=1.000). Inter-reader agreement ranged from fair (k=0.308) to substantial (k=0.633). Accuracy of the radiologist and orthopaedist ranged from 76% to 83% and from 68% to 72%, respectively. When comparing R2 and R0+R1 scores, the accuracy of both readers ranged from 83% to 100%. There was no association between local recurrence and margin scores of histology, MRI, and CT (p≥0.058). CONCLUSIONS: MRI and CT may be useful for extemporaneous analysis of resection margins of primary malignant bone tumours, although wide accuracy variability between the different imaging methods was observed.

AB - AIM: To evaluate the accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in assessing the resection margins of primary malignant bone tumours. MATERIALS AND METHODS: Resected primary malignant bone tumour specimens removed from 46 patients (27 male; mean age: 48±22 years) were imaged using MRI (fat-saturated proton density-weighted and three-dimensional fat-suppressed T1-weighted gradient-recalled-echo) and CT immediately after surgery. A radiologist and an orthopaedist evaluated bone and soft-tissue margins of the specimens on both examinations. Histological evaluation was performed by a senior orthopaedic oncology pathologist. Margins were classified as R0 (safe margins), R1 (residuals between 0 and 1 mm), and R2 (macroscopic residuals). Cohen's k, chi-square, and McNemar's statistics were used. RESULTS: Having histology as the reference standard, reproducibility of the radiologist ranged from moderate (k=0.544) to substantial (k=0.741) for bone and soft-tissue margins on CT, respectively, while that of the orthopaedist ranged from fair (k=0.316) to moderate (k=0.548). When comparing R2 and R0+R1 scores, reproducibility of readers' evaluation of bone margins increased ranging from substantial (k=0.655) to perfect (k=1.000). Inter-reader agreement ranged from fair (k=0.308) to substantial (k=0.633). Accuracy of the radiologist and orthopaedist ranged from 76% to 83% and from 68% to 72%, respectively. When comparing R2 and R0+R1 scores, the accuracy of both readers ranged from 83% to 100%. There was no association between local recurrence and margin scores of histology, MRI, and CT (p≥0.058). CONCLUSIONS: MRI and CT may be useful for extemporaneous analysis of resection margins of primary malignant bone tumours, although wide accuracy variability between the different imaging methods was observed.

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