title: MRI appearances of atypical cartilaginous tumour/grade I chondrosarcoma after treatment by curettage, phenolisation and allografting: recommendations for follow-up.
abstract: OBJECTIVE
  The purpose of this retrospective study was to differentiate between the MRI features of normal post-operative change and those of residual or recurrent disease after intralesional treatment of an atypical cartilage tumour (ACT)/grade I chondrosarcoma.
  
  
  METHODS
  We reviewed the case notes, radiology and histology of 75 patients, who had been treated for an ACT/grade I chondrosarcoma by curettage, phenolisation and bone allografting between 1994 and 2005. The first post-operative Gd-enhanced MRI scan was carried out within one year of surgery. Patients had a minimum of two scans and a mean follow-up of 72 months (13 to 169). Further surgery was undertaken in cases of suspected recurrence.
  
  
  RESULTS
  In 14 patients (18.6%) a second procedure was undertaken after a mean period of 59 months (8 to 114). Radio frequency ablation (RFA) was used in lesions of < 10 mm and curettage, phenolisation and bone grafting for those ≥ 10 mm. Only six of these (8% of total) had a histologically-proven recurrence. No increase in tumour grade was seen at time of recurrence.
  
  
  CONCLUSIONS
  Based on this study, we have been able to classify the post-operative MRI appearances into four groups. These groups differ in follow-up, and have a different risk of recurrence of the lesion. Follow-up and treatment vary for the patients in each group. We present a flow diagram for the appropriate and safe follow-up for this specific group of patients. Cite this article: Bone Joint J 2016;98-B:1674-81.
authors.affiliation: Alrijne Hospital, Simon Smitweg 1 2353 GA, Leiderdorp, The Netherlands.
authors.forename: S H M
authors.initials: SH
authors.lastname: Verdegaal
authors.affiliation: Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands.
authors.forename: C S
authors.initials: CS
authors.lastname: van Rijswijk
authors.affiliation: University Medical Center Groningen, Hanzeplein 1 9713 GZ, Groningen, The Netherlands.
authors.forename: H F C
authors.initials: HF
authors.lastname: Brouwers
authors.affiliation: Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands.
authors.forename: P D S
authors.initials: PD
authors.lastname: Dijkstra
authors.affiliation: Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: van de Sande
authors.affiliation: Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands.
authors.forename: P C W
authors.initials: PC
authors.lastname: Hogendoorn
authors.affiliation: Leiden University Medical Center, P.O. Box 9600, L-1-Q, Albinusdreef 2, 2300 RC Leiden, 2300 RC, The Netherlands.
authors.forename: A H M
authors.initials: AH
authors.lastname: Taminiau
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D016025:Bone Transplantation / Q000379:methods; D017115:Catheter Ablation / Q000379:methods; D002813:Chondrosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003475:Curettage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D018365:Neoplasm, Residual; D019800:Phenol / Q000627:therapeutic use; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies
chemical_list: D019800:Phenol
keywords: Bone neoplasm; Bone tumour; Chondrosacoma; Sarcoma; Treatment