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Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma

Tineke De Coninck (UGent) , Lennart Jans (UGent) , Gwen Sys (UGent) , Wouter Huysse (UGent) , Tom Verstraeten, Ramses Forsyth (UGent) , Bart Poffyn (UGent) and Koenraad Verstraete (UGent)
(2013) EUROPEAN RADIOLOGY. 23(11). p.3140-3152
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Abstract
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 (= 76A degrees) 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. - Standard MRI is complementary to DCE-MRI in differentiating cartilaginous tumours.
Keywords
Chondrosarcoma, Enchondroma, Dynamic, Differentiation, DCE-MRI, CARTILAGINOUS TUMORS, BONE-TUMORS, PERFUSION, FEATURES, LESIONS, BENIGN

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Chicago
De Coninck, Tineke, Lennart Jans, Gwen Sys, Wouter Huysse, Tom Verstraeten, Ramses Forsyth, Bart Poffyn, and Koenraad Verstraete. 2013. “Dynamic Contrast-enhanced MR Imaging for Differentiation Between Enchondroma and Chondrosarcoma.” European Radiology 23 (11): 3140–3152.
APA
De Coninck, T., Jans, L., Sys, G., Huysse, W., Verstraeten, T., Forsyth, R., Poffyn, B., et al. (2013). Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma. EUROPEAN RADIOLOGY, 23(11), 3140–3152.
Vancouver
1.
De Coninck T, Jans L, Sys G, Huysse W, Verstraeten T, Forsyth R, et al. Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma. EUROPEAN RADIOLOGY. 2013;23(11):3140–52.
MLA
De Coninck, Tineke, Lennart Jans, Gwen Sys, et al. “Dynamic Contrast-enhanced MR Imaging for Differentiation Between Enchondroma and Chondrosarcoma.” EUROPEAN RADIOLOGY 23.11 (2013): 3140–3152. Print.
@article{4163808,
  abstract     = {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 (= 76A degrees) 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.
- Standard MRI is complementary to DCE-MRI in differentiating cartilaginous tumours.},
  author       = {De Coninck, Tineke and Jans, Lennart and Sys, Gwen and Huysse, Wouter and Verstraeten, Tom and Forsyth, Ramses and Poffyn, Bart and Verstraete, Koenraad},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keyword      = {Chondrosarcoma,Enchondroma,Dynamic,Differentiation,DCE-MRI,CARTILAGINOUS TUMORS,BONE-TUMORS,PERFUSION,FEATURES,LESIONS,BENIGN},
  language     = {eng},
  number       = {11},
  pages        = {3140--3152},
  title        = {Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma},
  url          = {http://dx.doi.org/10.1007/s00330-013-2913-z},
  volume       = {23},
  year         = {2013},
}

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