The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
H T Temple - One of the best experts on this subject based on the ideXlab platform.
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enchondroma versus chondrosarcoma in the Appendicular Skeleton differentiating features
Radiographics, 1998Co-Authors: Mark D Murphey, Donald J Flemming, S R Boyea, J A Bojescul, Donald E Sweet, H T TempleAbstract:Distinction of enchondroma versus intramedullary chondrosarcoma affecting the Appendicular Skeleton (proximal to the metacarpals and metatarsals) is a frequent diagnostic dilemma. The authors studied a large series of patients with these lesions (92 with enchondromas, 95 with chondrosarcomas) using statistical assessment of both clinical parameters and numerous radiologic manifestations on images from multiple modalities to identify differentiating features. Multiple clinical and imaging parameters demonstrated statistically significant differences between enchondroma and chondrosarcoma, particularly pain related to the lesion, deep endosteal scalloping (greater than two-thirds of cortical thickness), cortical destruction and soft-tissue mass (at computed tomography or magnetic resonance imaging), periosteal reaction (at radiography), and marked uptake of radionuclide (greater than the anterior iliac crest) at bone scintigraphy. All of these features strongly suggested the diagnosis of chondrosarcoma. The...
Daniela Militianu - One of the best experts on this subject based on the ideXlab platform.
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added value of spect ct in the evaluation of benign bone diseases of the Appendicular Skeleton
Clinical Nuclear Medicine, 2016Co-Authors: Gad Abikhzer, Saher Srour, Zohar Keidar, Rachel Barshalom, Olga Kagna, Ora Israel, Daniela MilitianuAbstract:Bone scintigraphy is a sensitive technique to detect altered bone mineralization but has limited specificity. The use of SPECT/CT has improved significantly the diagnostic accuracy of bone scintigraphy, in patients with cancer as well as in evaluation of benign bone disease. It provides precise localization and characterization of tracer-avid foci, shortens the diagnostic workup, and decreases patient anxiety. Through both the SPECT and the CT components, SPECT/CT has an incremental value in characterizing benign bone lesions, specifically in the Appendicular Skeleton, as illustrated by present case series.
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Added Value of SPECT/CT in the Evaluation of Benign Bone Diseases of the Appendicular Skeleton.
Clinical Nuclear Medicine, 2016Co-Authors: Gad Abikhzer, Saher Srour, Zohar Keidar, Olga Kagna, Ora Israel, Rachel Bar-shalom, Daniela MilitianuAbstract:Bone scintigraphy is a sensitive technique to detect altered bone mineralization but has limited specificity. The use of SPECT/CT has improved significantly the diagnostic accuracy of bone scintigraphy, in patients with cancer as well as in evaluation of benign bone disease. It provides precise localization and characterization of tracer-avid foci, shortens the diagnostic workup, and decreases patient anxiety. Through both the SPECT and the CT components, SPECT/CT has an incremental value in characterizing benign bone lesions, specifically in the Appendicular Skeleton, as illustrated by present case series.
Kosei Matsue - One of the best experts on this subject based on the ideXlab platform.
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Medullary Abnormalities in Appendicular Skeletons Detected With 18F-FDG PET/CT Predict an Unfavorable Prognosis in Newly Diagnosed Multiple Myeloma Patients With High-Risk Factors.
American Journal of Roentgenology, 2019Co-Authors: Kentaro Narita, Masami Takeuchi, Hiroki Kobayashi, Akihiro Kitadate, Toshihiro O'uchi, Kosei MatsueAbstract:OBJECTIVE. The prognostic value of medullary abnormalities in the Appendicular Skeleton (AS) of patients with multiple myeloma (MM) has recently been suggested. However, functional evaluation of th...
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prognostic significance of bone marrow abnormalities in the Appendicular Skeleton of patients with multiple myeloma
Blood Advances, 2018Co-Authors: Kosei Matsue, Yuya Matsue, Hiroki Kobayashi, Kentaro Narita, Akihiro Kitadate, Masami TakeuchiAbstract:We aimed to determine the clinical and prognostic significance of medullary abnormalities detected by low-dose whole-body multidetector computed tomography (MDCT) in the Appendicular Skeleton (AS) of patients with newly diagnosed symptomatic multiple myeloma (MM). One hundred ninety-six patients underwent low-dose whole-body MDCT as an initial workup. Patients were categorized into 3 groups based on the medullary pattern of the AS: fatty (36.3%), focal (43.4%), and diffuse (20.4%). Medullary abnormalities were associated with Durie-Salmon and revised International Scoring System stage 3, creatinine levels >2.0 mg/dL, and the proportion of bone marrow plasma cells. The median follow-up was 35.4 months. Patients with fatty, focal, and diffuse patterns had a median survival of not reached, 56 months, and 38 months, respectively. Overall survival (OS) was associated with age, Durie-Salmon stage 3, creatinine levels >2.0 mg/dL, ineligibility for autologous stem cell transplantation, and focal and diffuse patterns on univariate analysis. Multivariate analysis showed that age and diffuse pattern (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.12-3.31; P = .018) were independent predictors of progression-free survival. Age and focal (HR, 2.51; 95% CI, 1.14-5.56; P = .023) and diffuse (HR, 4.12; 95% CI, 1.74-9.77; P = .001) patterns were also independent predictors of OS. The addition of marrow pattern to preexisting risk factors was associated with a net reclassification improvement for predicting OS (to 0.37, P = .015). Medullary abnormalities in the AS (detected by low-dose whole-body MDCT) are associated with a poor prognosis, independent of other clinical variables.
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clinical and prognostic significance of bone marrow abnormalities in the Appendicular Skeleton detected by low dose whole body multidetector computed tomography in patients with multiple myeloma
Blood Cancer Journal, 2015Co-Authors: Yuki Nishida, Yuya Matsue, Yasuhito Suehara, Kota Fukumoto, Manabu Fujisawa, Masami Takeuchi, E Ouchi, Kosei MatsueAbstract:Clinical and prognostic significance of bone marrow abnormalities in the Appendicular Skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma
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bone marrow imaging of Appendicular Skeleton by multi detector computed tomography in patients with aplastic anemia and hypoplastic mds
Blood, 2012Co-Authors: Tomotaka Ugai, Yuki Nishida, Masami Takeuchi, Hiroki Sugihara, Masayuki Yamakura, Kosei MatsueAbstract:Abstract 2817 Background: Myelodysplastic syndrome (MDS) and aplastic anemia (AA) are the heterogeneous group of bone marrow failure disorders. AS both shows profound hypocellular marrow without minimal morphologic atypia, differentiation of MDS and AA is often difficult by bone marrow and laboratory examination alone. Red to yellow marrow conversion is occurs with age in the Appendicular Skeleton (AS), where red marrow is converted to yellow marrow until the age of early 20s. Although abnormal distribution of red marrow in Appendicular Skeleton has previously reported in small series of patients with MDS, leukemia and lymphoma by MRI, no further study has published so far. Here, we examined distribution of red marrow in AS by low-dose multi-detector CT (MDCT) in AA and MDS. We analyzed the relationship between the abnormal medullary pattern in AS with laboratory variables, subsequent development of leukemic transformation and survivals MDS patients. Patients: We performed a low-dose MDCT of humerus and femurs in 64 untreated adult patients with AA (N=15) and MDS (N=49). Retrospective review of clinical and laboratory features including complete blood count, % of bone marrow blast, chromosomal analysis, and International Prognostic Scoring System (IPSS) was performed. WHO classification of MDS patients was as follows: RA (N=17), RARS (N=2), RCMD (N=9), RAEB (N=19) and MDS unclassified (N=2). Overall survival (OS) and leukemia-free survival (LFS) were analyzed in 49 MDS patients by the Kaplan-Meier and differences between curves were calculated by two-sided log-rank test. Multivariate analysis was Used to assess the effects of prognostic factors - hemoglobin, platelet, bone marrow blast, cytogenetic abnormalities, IPSS score, WHO classification, and MDCT patterns. CT image acquisition and Image analysis: Non-enhanced CT examinations were performed from the base of skull down to the knee joint by MS-CT scanner (AQUILION 64, Tohshiba, Tokyo, Japan). Bony canal of humeral and femoral bone were visualized by coronal and sagittal axis image reconstruction. The effective radiation dose associated with whole body MD-CT was 10.1 mSv. (ICRP 26). The dose was comparable to whole body CT (2.4 mSv.). Medullary CT density of humerus and femurs were measured and the results were expressed as Hounsfield unit (HU). As the normal adult bone marrow was composed of rich adipocytes and called yellow marrow, it is represented by low density CT value between −30 to −100 HU. The value above −30 HU observed in long bony canals was considered as high density lesions. Medullary pattern of Appendicular Skeletons were categorized as follows: (1) fatty; showing a low signal density marrow (2) focal; showing abnormally focal high density lesions: (3) diffuse; showing uniformly high density marrow. Results: All 15 patients with AA showed a fatty (N=10, 66%) or focal (N=5, 33%) pattern in medullary AS on MDCT and none of them showed diffuse pattern. Conversion from fatty to focal marrow was observed in 9 of 15 AA patients after successful immunosuppressive treatment. Among the 49 patients with MDS, 15 (31%) had fatty pattern, 21 (43%) had focal pattern, and 13 (27%) had diffuse pattern. Patients with diffuse infiltration pattern on MDCT had a significantly low hemoglobin concentration (p Conclusions: This study showed that MDCT imaging of the Appendicular Skeletons provided important information for the diagnosis and prognosis of patients with MDS and AA. Disclosures: No relevant conflicts of interest to declare.
Domenico Andrea Campanacci - One of the best experts on this subject based on the ideXlab platform.
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the treatment of metastases in the Appendicular Skeleton
Journal of Bone and Joint Surgery-british Volume, 2001Co-Authors: R Capanna, Domenico Andrea CampanacciAbstract:Bone metastases from carcinomata are a medical and social issue. About one-half of all primary cancers tend to disseminate to the Skeleton, which is the third most frequent site of metastatic spread after the lung and the liver. Epidemiological investigation has shown that of 1.2 million new cases of cancer each year in the USA, about 300 000 will eventually develop a bone metastasis. Tumours which have a predilection for dissemination to bone are those of the prostate (32%), breast (22%) and kidney (16%) followed by the lung and the thyroid. The sites most usually involved are, in order of frequency, the spine, pelvis, ribs, skull and proximal long bones. The treatment of bone metastases is usually palliative and aims to achieve adequate control of pain, to prevent and resolve compression of the cord in lesions of the spine and to anticipate or stabilise pathological fractures in the Appendicular Skeleton. In selected cases the complete resection of an isolated bone metastasis may improve the survival of the patient. The prognosis of patients with bone metastases is extremely variable depending on the site of the primary growth. During recent decades, the life expectancy of patients affected with metastatic carcinoma has improved considerably because of advances in chemotherapy, immunotherapy, hormonal treatment and radiotherapy. However, this improvement results in an increase in the population at risk of developing bone metastases or experiencing a pathological fracture. The reconstructive procedure requires greater reliability in order to avoid mechanical failure during prolonged survival of the patient. At present, the treatment of bone metastases may not follow any codified protocol. The patient may be treated by different specialists such as an orthopaedic surgeon, an oncologist or a radiotherapist without any rational guideline as to the indications for surgical treatment. We have recently introduced a new protocol for the treatment of bone metastases of the Appendicular Skeleton which describes guidelines for indications for surgery, the type of operation to be undertaken and the methods of reconstruction available. The aim is to offer adequate individual treatment to the patient, avoiding undertreatment or overtreatment, to achieve control of pain and to manage impending and pathological fractures so that the longer survival is associated with a better quality of life.
Jose Juan Pozo Kreilinger - One of the best experts on this subject based on the ideXlab platform.
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enchondroma versus chondrosarcoma in long bones of Appendicular Skeleton clinical and radiological criteria a follow up
Journal of Oncology, 2016Co-Authors: Eugenio M Ferrersantacreu, Eduardo J Ortizcruz, Mariana Diazalmiron, Jose Juan Pozo KreilingerAbstract:As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist: enchondroma (E), a benign tumor, and chondrosarcoma (LGC), a malignant and low aggressiveness tumor. A prospective study of 133 patients with a cartilaginous tumor of low aggressiveness in the long bones of the Appendicular Skeleton was done to prove this difficult differential diagnosis. Parameters including medical history and radiological and nuclear imaging were collected and compared to the result of the biopsy. A scale of aggressiveness was applied to each patient according to the number of aggressiveness episodes present. A comparison of the results of the biopsy with the initial diagnosis made by the orthopedic oncologist based solely on clinical data and imaging tests was also made. Finally, a management algorithm for these cases was proposed. A statistical significance for LGC resulted from the parameter as follows: pain on palpation, involvement of cortical in either the CT or MRI, and Tc99 bone scan uptake equal or superior to anterosuperior iliac crest. In our series, a tumor scoring 5 points or higher in the scale of aggressiveness can have 50% more chance of being LGC. When compared with the gold standard (the biopsy), surgeon's initial judgement showed a sensitivity of 73.5% and a specificity of 94.1%.
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Enchondroma versus Chondrosarcoma in Long Bones of Appendicular Skeleton: Clinical and Radiological Criteria—A Follow-Up
Journal of Oncology, 2016Co-Authors: Eugenio M. Ferrer-santacreu, Eduardo J. Ortiz-cruz, Mariana Díaz-almirón, Jose Juan Pozo KreilingerAbstract:As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist: enchondroma (E), a benign tumor, and chondrosarcoma (LGC), a malignant and low aggressiveness tumor. A prospective study of 133 patients with a cartilaginous tumor of low aggressiveness in the long bones of the Appendicular Skeleton was done to prove this difficult differential diagnosis. Parameters including medical history and radiological and nuclear imaging were collected and compared to the result of the biopsy. A scale of aggressiveness was applied to each patient according to the number of aggressiveness episodes present. A comparison of the results of the biopsy with the initial diagnosis made by the orthopedic oncologist based solely on clinical data and imaging tests was also made. Finally, a management algorithm for these cases was proposed. A statistical significance for LGC resulted from the parameter as follows: pain on palpation, involvement of cortical in either the CT or MRI, and Tc99 bone scan uptake equal or superior to anterosuperior iliac crest. In our series, a tumor scoring 5 points or higher in the scale of aggressiveness can have 50% more chance of being LGC. When compared with the gold standard (the biopsy), surgeon's initial judgement showed a sensitivity of 73.5% and a specificity of 94.1%.
