Abstract
The differential diagnosis of Ewing sarcoma and osteomyelitis can be challenging and can lead to delays in treatment with possibly devastating results. In this retrospective, small-cohort study we demonstrate, that the Fourier Transformed Infrared (FTIR) spectra of osteomyelitis bone tissue can be differentiated from Ewing sarcoma and normal bone tissue sampled outside tumour area. Significant differences in osteomyelitis samples can be seen in lipid and protein composition. Supervised learning using a quadratic discriminant analysis classifier was able to differentiate the osteomyelitis samples with high accuracy. FTIR spectroscopy, alongside routine radiological and histopathological methods, may offer an additional tool for the differential diagnosis of osteomyelitis and ES.
Highlights
Ewing sarcoma (ES) is a poorly differentiated tumour of bones or soft tissues derived from primitive mesenchymal stem cells
Fourier Transformed Infrared (FTIR) spectroscopy can be applied to early stages of a disease, before tissue changes are detectable by light microscopy
Samples were allocated to three study groups: group I – normal bone tissue sampled outside the area of ES infiltration after neoadjuvant chemotherapy completion (20 samples), group II – osteomyelitis bone tissues (10 samples) and 27 ES bone tissues collected during a diagnostic biopsy
Summary
Ewing sarcoma (ES) is a poorly differentiated tumour of bones or soft tissues derived from primitive mesenchymal stem cells. This tumour is the second most common bone malignancy with 2.9 cases per million population (below the age of 20). Misdiagnosis of Ewing Sarcoma and the bone disease osteomyelitis is well-reported due to the similarities in their presentation In both delayed or misdiagnosis can lead to adverse clinical outcomes. FTIR measures the absorption of infrared radiation by the chemical bonds in constituent molecules of a sample It provides bulk information about the biochemical composition of a sample as opposed to immunohistochemistry or other molecular techniques that selectively target specific macromolecule types[5]. The FTIR features of Ewing sarcoma infected bone tissue have been previously reported[8], to-date no study has reported the FTIR spectroscopic features of osteomyelitis nor compared those with Ewing Sarcoma to determine whether they differ
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