ABSTRACT
Decisions regarding the surgical approach in osteosarcoma require accurate assessment of tumor extent. In order to determine whether enhancement with gadopentetate dimeglumine could add clinically significant information to that available with unenhanced MR imaging, 21 patients with osteosarcoma underwent preoperative MR imaging. T1- and T2-weighted spin-echo MR images obtained before and after administration of IV gadopentetate dimeglumine were evaluated to determine the conspicuity of marrow and soft-tissue extent of tumor, including tumor involvement of major neurovascular bundles and adjacent joints. MR results were correlated with tumor margins found at surgery. In some instances, use of gadopentetate dimeglumine obscured differentiation of tumor from normal marrow or tumor infiltration into perineurovascular fat, and tumor extension through pseudocapsule could not be differentiated from peritumoral edema after contrast administration. Contrast enhancement did assist in differentiation of intraarticular tumor from effusion; however, synovial invasion could be identified on unenhanced T1-weighted images by loss of synovial fat and cortical disruption. These results indicate that gadopentetate dimeglumine does not assist in defining tumor margins of osteosarcoma.
Subject(s)
Bone Neoplasms/diagnosis , Magnetic Resonance Imaging , Organometallic Compounds , Osteosarcoma/diagnosis , Pentetic Acid , Adolescent , Adult , Aged , Bone Marrow/pathology , Bone Neoplasms/surgery , Female , Femoral Neoplasms/diagnosis , Gadolinium DTPA , Humans , Humerus/pathology , Male , Middle Aged , Osteosarcoma/surgery , Tibia/pathologyABSTRACT
The evolution of mammography from simple radiography of mastectomy specimens to the foremost method of breast cancer screening has been dependent on its creators and nurturers, people with intense vision, idealism, and scientific skill. Society owes these investigators a debt of gratitude that can never be adequately repaid.
