Anita Sonya Chae MD, Presenter: Nothing to Disclose

Lawrence M. White MD, Abstract Co-Author: Nothing to Disclose

To review the magnetic resonance (MR) imaging findings and signal characteristics of giant cell tumor (GCT) of bone.

The preoperative MR studies of 48 consecutive patients (25 male, 23 female; mean age 33, range 17-79) with histopathologically confirmed GCT of bone were retrospectively reviewed by two musculoskeletal radiologists with agreement by consensus. All images were acquired on a 1.5T MR system. Tumor signal intensity was assessed relative to muscle on T1W and fat-suppressed T2W imaging. The extent of tumor signal void was graded as comprising: 50% of the tumor volume. In addition, the presence/absence of perilesional marrow edema, intralesional cystic components, fluid-fluid levels, a peripheral rim of low signal intensity, soft tissue extension, intraarticular spread, and the occurrence of pathological fracture were assessed in all cases.

On T1W images, 45/48 (94%) lesions were isointense, and 3/48 (6%) hypointense relative to muscle. On T2W sequences 45/48 (94%) tumors demonstrated heterogeneous but predominant mild hyperintensity relative to muscle, and 3/48 (6%) predominant hypointensity. Signal void on T2W imaging comprised 50% of the tumor volume in 3/48 (6%) cases. Perilesional marrow edema was present in 39/48 (81%) cases, absent in 9/48 (19%). 31/48 (65%) tumors exhibited intralesional cystic components, 15/48 (31%) fluid-fluid levels, and 21/48 (44%) a peripheral demarcating rim of low T1 and T2 signal. 27/48 (56%) tumors showed extraosseous soft tissue extension, 13/48 (27%) intraarticular extension, and 6/48 (16%) patients had a pathologic fracture.

GCT of bone most frequently demonstrates T1 isointensity (94%) and heterogeneous, mild T2 hyperintensity (94%) on MR examination, with predominant intratumoral signal void a relatively infrequent finding (6%). Perilesional marrow edema, extraosseous soft tissue extension, intralesional cystic change, fluid-fluid levels and tumor demarcation by a peripheral rim of low signal intensity are additional common MR imaging features of GCT.

To review the magnetic resonance (MR) imaging findings and signal characteristics of giant cell tumor (GCT) of bone.

The preoperative MR studies of 48 consecutive patients (25 male, 23 female; mean age 33, range 17-79) with histopathologically confirmed GCT of bone were retrospectively reviewed by two musculoskeletal radiologists with agreement by consensus. All images were acquired on a 1.5T MR system. Tumor signal intensity was assessed relative to muscle on T1W and fat-suppressed T2W imaging. The extent of tumor signal void was graded as comprising: 50% of the tumor volume. In addition, the presence/absence of perilesional marrow edema, intralesional cystic components, fluid-fluid levels, a peripheral rim of low signal intensity, soft tissue extension, intraarticular spread, and the occurrence of pathological fracture were assessed in all cases.

On T1W images, 45/48 (94%) lesions were isointense, and 3/48 (6%) hypointense relative to muscle. On T2W sequences 45/48 (94%) tumors demonstrated heterogeneous but predominant mild hyperintensity relative to muscle, and 3/48 (6%) predominant hypointensity. Signal void on T2W imaging comprised 50% of the tumor volume in 3/48 (6%) cases. Perilesional marrow edema was present in 39/48 (81%) cases, absent in 9/48 (19%). 31/48 (65%) tumors exhibited intralesional cystic components, 15/48 (31%) fluid-fluid levels, and 21/48 (44%) a peripheral demarcating rim of low T1 and T2 signal. 27/48 (56%) tumors showed extraosseous soft tissue extension, 13/48 (27%) intraarticular extension, and 6/48 (16%) patients had a pathologic fracture.

GCT of bone most frequently demonstrates T1 isointensity (94%) and heterogeneous, mild T2 hyperintensity (94%) on MR examination, with predominant intratumoral signal void a relatively infrequent finding (6%). Perilesional marrow edema, extraosseous soft tissue extension, intralesional cystic change, fluid-fluid levels and tumor demarcation by a peripheral rim of low signal intensity are additional common MR imaging features of GCT.

Chae, A, White, L, Magnetic Resonance Imaging Characteristics of Giant Cell Tumor of Bone.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4413193.html