title: Wide area detector CT perfusion: can it differentiate osteoid osteomas from other lytic bone lesions?
abstract: OBJECTIVE
  To compare the enhancement dynamics of osteoid osteomas with other benign and malignant lytic bone lesions using CT perfusion.
  
  
  METHODS
  CT perfusion parameters of 15 patients with a final diagnosis of osteoid osteoma, 15 patients with lesions that mimic osteoid osteomas and 26 patients with other bone lytic lesions were compared.
  
  
  RESULTS
  Enhancement curve morphology of the osteoid osteomas was significantly different from its mimickers. All osteoid osteomas had an early enhancement with a delay between nidus and arterial peak below 30 seconds. Eighty percent of the mimickers demonstrated a slow and progressive enhancement. The perfusion parameters of the other lytic bone lesions were similar to those of the osteoid osteomas in 46.1% of the patients.
  
  
  CONCLUSIONS
  Early enhancement is suggestive but not pathognomonic of osteoid osteomas. Absent or delayed enhancement in similar lesions should evoke an alternative diagnosis. The same contrast enhancement dynamics of osteoid osteomas can be seen in other bone lesions, both malignant and benign.
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France; Université de Lorraine, IADI, UMR S 947, Tour Drouet, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France. Electronic address: ped_gt@hotmail.com.
authors.forename: P A
authors.initials: PA
authors.lastname: Gondim Teixeira
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France.
authors.forename: S
authors.initials: S
authors.lastname: Lecocq
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Louis
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France.
authors.forename: S
authors.initials: S
authors.lastname: Aptel
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: Raymond
authors.affiliation: Service de chirurgie traumatologique et orthopédique, centre chirurgical Emile-Gallé, 54000 Nancy, France.
authors.forename: F
authors.initials: F
authors.lastname: Sirveaux
authors.affiliation: Service d'imagerie Guilloz, hôpital Central, CHU de Nancy, 54000 Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: Blum
mesh_terms: D000328:Adult; D000368:Aged; D001847:Bone Diseases / Q000175:diagnosis*; D001859:Bone Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010017:Osteoma, Osteoid / Q000175:diagnosis*; D055420:Perfusion Imaging; D011446:Prospective Studies; D055815:Young Adult
keywords: Bone neoplasms; Differential diagnosis; Multidetector computed tomography; Osteoid osteoma; Perfusion imaging