Musculoskeletal X–Ray and MRI evaluation of Bone Tumour with its Histopathological correlation

Introduction- Bone tumours are uncommon malignancy but having significant cancer morbidity and mortality which can only reduce by early and accurate diagnosis .Our study is carried out to measure the strength of agreement in Clinical, Radiological and Histopathological diagnosis of all Bone Tumours from September 2014 to November 2015using 1.5 Tesla Philips Achieva magnetic resonance imaging machine, at the Radiology Department of GOVT. MEDICAL COLLEGE AND ASSOCIATED GROUP OF HOSPITALS, KOTA. Result: In our study total no of 30 cases of bone tumour and tumour like lesion is carried out within one year duration in hadoti region.Malignant tumours were more commonly encountered constituting 46.6 % of the total lesions, 20-29 year age group predominantly affected. Male: Female ratio – 1.30:1.Chondrogenic (29.97%)and Osteogenic tumours (13.3%) and giant cell tumour (13.3%) were commonest lesions. MRI shows excellent sensitivity and specificity in soft tissue involvement, neurovascular involvement and joint involvement. Introduction- Bone lesions are diverse in size, gross and histologic feature. This diversity makes it critical to diagnose bone tumours correctly, stage them accurately and treat them appropriate 1 .A systematic approach to clinical history, radiographic evaluation and histopathology is necessary for accurate diagnosis 2 .Radiography is the optimal initial imaging modality for evaluating undiagnosed bone tumours 3 Although traditionally Magnetic resonance Imaging is used in  evaluation of musculoskeletal tumours and extent of disease prior to treatment, its role continues to evolve as new techniques emerge 4 .A combination of the signal intensity characteristics, site, and morphology of the tumour on MRI images and the presence or absence of abnormal signal intensity adjacent to the tumour can allow the radiologist to categorize many tumours as benign or malignant. 5 MRI is very helpful in local staging and surgical planning by assessing the degree of intramedullary extension and invasion of the adjacent physealplates,bone marrow lesion, joints, muscle compartments and neurovascular bundles involvement as well as in assessing response to neoadjuvant therapy and post-therapeutic follow-up. 6 Subject and methods- X-Ray and MRI studies along with histopathological analysis is studied of 30 patient from September 2014 to November 2015, using 1.5 Tesla Philips achieva magnetic resonance imaging machine, at the Radiology Department of GOVT. MEDICAL COLLEGE AND ASSOCIATED GROUP OF HOSPITALS, KOTA .However sample size is small in our study but it can make an excellent contribution even in that particular small sample size. All patient was examined using 1.5 tesla Philips machine pulse sequence used are  T1w, T2w, in coronal plane using body coil followed by T1w and T2w  sequences in axial plane supplemented by sagittal and coronal plane using surface coil, second plane of imaging included STIR sequence and post contrast fat sat T1w images. T1W-often thought of as making an anatomical image, as it produces excellent contrast between cortical bones, bone marrow and surrounding soft tissues.  (TR/TE-500-760/15-30ms) T2- considered to produce a pathological scan which show high signal within the most tumour due to their increased water content, fast modification of standard se pulse sequence is preferred because it often shorter imaging times.(TR/TE-2200-2700/80-100ms) GADOLINIUM ENHANCED SE-important for characterization of bone tumour as well as for assessment of response to therapy and recurrence of tumour.(TR/TE-3000-3500/96-102ms)performed if required. STIR-short tau inversion recovery frequently used. Specific T1 is proportional to the magnetic field strength at 1.5 tesla T1 is 140-160 ms. Contrast used: Magnevist - Dimegluminegadopentetate (469 mg/ml) Dose of contrast – 0.1 ml/Kg body weight. No contrast reactions were encountered. Scan time varied from 17 mins to 25 mins. Interpretation of Imaging –Studies are observed by senior radiologists in our department having 10 to 20 year of experience.