Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor.

A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

Three-dimensional spin-lock magnetic resonance imaging of the shoulder joint at 3 T: initial experience.

OBJECTIVES: This was a pilot study which aimed to assess the feasibility of 3D-spin-lock (3D-T(1rho)) MRI of the shoulder joint and to establish baseline values of healthy humeral and glenoid cartilages in vivo. MATERIAL AND METHODS: Four asymptomatic volunteers [mean age 31 years (range 29-36 years)] were recruited. A 3.0 T scanner, employing a four-channel, phased-array, shoulder, radio-frequency (RF) coil was used. Three-dimensional T(1rho)-weighted images were acquired with a 3D gradient-echo (GRE) sequence with T(1rho) magnetization preparation. In order to a construct T(1rho) map, we acquired four 3D-T(1rho)-weighted images with spin-locking length (TSL) values of 2 ms, 10 ms, 20 ms, and 30 ms. The glenoid and humeral cartilage were segmented manually at each slice of the 3D images. We performed additional regional analysis by dividing the cartilage into anterior/posterior and superior/inferior regions. RESULTS: The global average T(1rho) value of the shoulder cartilages varied from 37.9 ms to 48.5 ms and from 32.4 ms to 36.9 ms for humeral and glenoid cartilages, respectively. In the humeral cartilage, the average regional T(1rho) values varied from 35.9 ms to 52.2 ms; 54.4 ms to 69.0 ms; 39.1 ms to 49.3 ms and 34.6 ms to 57.2 ms for the anterior-superior, anterior-inferior , posterior-superior and posterior-inferior regions, respectively. In the glenoid cartilage, the values varied from 31.3 ms to 40.8 ms; 34.1 ms to 35.3 ms; 26.7 ms to 37.2 ms and 32.8 ms to 35.7 ms for the same regions, respectively. CONCLUSION: We demonstrated that 3D-T(1rho) MRI of the shoulder can be performed on a 3 T clinical scanner within specific absorption rate (SAR) limits, and we present baseline values for healthy patients which may be useful for quantitative comparison with diseased shoulders.