title: Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma.
abstract: OBJECTIVE
  To determine whether dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can differentiate benign from malignant cartilage tumours compared to standard MRI. To investigate whether a cutoff value could be determined to differentiate enchondroma from low-grade chondrosarcoma (CS) more accurately.
  
  
  METHODS
  One hundred six patients were included in this retrospective study: 75 with enchondromas (mean age = 41 years) and 31 with CS (mean age = 47 years). Within this population, a subgroup of patients was selected with the tumour arising in a long bone. At the time of diagnosis, the tumours were evaluated on MRI, including standard MRI, DCE-MRI, and region-of-interest (ROI) analysis to obtain information on tumour vascularisation and perfusion.
  
  
  RESULTS
  The main cutoff value to differentiate enchondroma from CS contained a two-fold more relative enhancement compared with muscle, combined with a 4.5 (= 76°) slope value, with 100 % sensitivity and 63.3 % specificity. The prediction of CS diagnosis with DCE-MRI had 93.4 % accuracy. The accuracy of the standard MRI parameters was equal to the DCE-MRI parameters.
  
  
  CONCLUSIONS
  Standard MRI and DCE-MRI both play an important and complementary role in differentiating enchondroma from low-grade CS. A combination of both imaging techniques leads to the highest diagnostic accuracy for differentiating cartilaginous tumours.
  
  
  CONCLUSIONS
  • DCE-MRI plays an important role in differentiating benign from malignant cartilage tumours. • Retrospective study defined a threshold for 100 % detection of chondrosarcoma with DCE-MRI. • The threshold values were relative enhancement = 2 and slope = 4.5. • One hundred per cent chondrosarcoma detection corresponds with 36.7 % false-positive diagnosis of enchondroma. • Standard MRI is complementary to DCE-MRI in differentiating cartilaginous tumours.
authors.affiliation: Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, tineke.deconinck@ugent.be.
authors.forename: T
authors.initials: T
authors.lastname: De Coninck
authors.forename: L
authors.initials: L
authors.lastname: Jans
authors.forename: G
authors.initials: G
authors.lastname: Sys
authors.forename: W
authors.initials: W
authors.lastname: Huysse
authors.forename: T
authors.initials: T
authors.lastname: Verstraeten
authors.forename: R
authors.initials: R
authors.lastname: Forsyth
authors.forename: B
authors.initials: B
authors.lastname: Poffyn
authors.forename: K
authors.initials: K
authors.lastname: Verstraete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis*; D002648:Child; D002812:Chondroma / Q000175:diagnosis*; D002813:Chondrosarcoma / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media