DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING IN DIAGNOSING BONE TUMORS KEEPING HISTOPATHOLOGICAL CORRELATION AS GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of magnetic resonance imaging in diagnosing bone tumors keeping histopathological as correlation gold standard. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Departments of Radiology, Orthopedics and Pathology of Pakistan Institute of Medical Sciences, Islamabad, from Jan 2018 to Jan 2019. Methodology: All the patients who had complain of bone deformity or pain with high suspicion of neoplastic pathology involving bone and soft tissue on radiograph were included in study. Patients were first diagnosed on conventional radiography followed by magnetic resonance imaging. Magnetic resonance imaging with contrast was done on Phillips 1.5 tesla machine. T1W, T2W, STIR images, Fat suppressed, PD spair and post contrast T1W images were obtained. Positive magnetic resonance imaging findings which were noted were; marrow involvement, cortical break, soft tissue involvement, joint involvement, neurovascular bundle involvement and post contrast enhancement on T1W imaging. Then bone biopsy was performed. The removed bone was sent for histopathological examination in all cases. The histopathological reports were collected. The results were entered in structured proformas. Data was collected after the informed consent. All the data was entered and analyzed using SPSS version-23. Results: Fifty patients of both genders were recruited during our study duration. 32 (64.0%) were male while 18 (36.0%) were female patients. Mean age of the patient was 54.5 ± 14.3 years with range 18 to 80 years. Among the benign tumors vertebral hemangiomas were most commonly found 5 (10.0%) followed by osteochondroma which was 4 (8.0%), while among malignant tumors metastatic deposits/secondaries were most commonly found 11 (22.0%), followed by multiple myeloma 6 (12.0%) then Ewing Sarcoma and Osteosarcomas. Study showed sensitivity, specificity and accuracy in differentiating benign from malignant of 94.12%, 90% and 92.59%. Conclusion: In evaluating bone tumors, magnetic resonance imaging plays an important role. Whenever a bony pathology is detected that cannot be characterized and shows features of aggressive pathology magnetic resonance imaging is indicated. Magnetic resonance imaging is superior in detecting osseous lesions with marrow invasion and soft tissue component. It is helps to locally stage the disease, and by identifying the perilesional invasion and extension it helps the surgeon to plan the surgery. It is also used to assess the response of neoadju-vant therapy followed by restaging. It can further be used for follow up assessment of patient after completion of treatment.

Keywords

• bone tumor
• diagnostic accuracy
• gold standard
• histopathology
• magnetic resonance imaging