Abstract
BackgroundOsteoblastoma (OB) is an intermediate lesion, which makes the accurate preoperative diagnosis very important. 99mTc-methylene diphosphonate (99mTc-MDP) bone scan and SPECT/CT imaging were evaluated for their diagnostic value in spinal OB.MethodsThis study was a retrospective analysis of patients with spinal OB lesions confirmed by pathology and diagnosed with bone scan and SPECT/CT for preoperative diagnosis from January 2008 to December 2018. The uptake levels of OB on planar bone scan were divided into low, medium, and high groups by visual assessment referring to the uptake of the normal rib, spine, and bladder. X-ray, CT, MRI, bone scan, and SPECT/CT imaging of the patients were analyzed for characteristics summary.ResultsTwenty-five patients were diagnosed for spinal OB (17 males and 8 females with a proportion of 2.1:1), and the average age was 26.8 ± 10.8 years (range 5~59). There were 8 lesions located in the cervical, 6 in the thoracic, and 11 in the lumbar vertebrae. Twenty-four lesions involved posterior elements, especially the pedicles (14/25). Symptoms were predominantly painful with a duration of 18.3 ± 13.9 months (range 0.5~60 months). The lesion size ranged from 9 to 35 mm. All the lesions were low to high uptake in the planar bone scan, and the percentages of low to high levels were 1 (4%), 8 (32%), and 16 (64%) cases.ConclusionsSpinal OB mainly involved the posterior area, and elderly patients should be considered as well. SPECT/CT combined the characteristics of bone uptake and anatomical features of bone tumors, proving its one-in-all diagnostic value for spinal OB and other osteogenic tumors.
Highlights
Osteoblastoma (OB) is a rare and primary bone neoplasm which was first described by Jaffe and Lichtenstein in the 1950s, accounting for 1% of all primary bone tumors and around 3% of benign bone tumors [1,2,3]
All patients were investigated by the following imaging resources performed in our hospital: plain X-rays, computed tomography (CT) scan, magnetic resonance imaging (MRI), bone scan, and Single-photon emission tomography (SPECT)/CT
80~90% of cases are diagnosed before 30 years of age reported in the literature, 36% of patients (9/25) in our study were diagnosed after 30 years old
Summary
Osteoblastoma (OB) is a rare and primary bone neoplasm which was first described by Jaffe and Lichtenstein in the 1950s, accounting for 1% of all primary bone tumors and around 3% of benign bone tumors [1,2,3]. OB is commonly located in the spine (35–50%) and usually in the posterior elements. When the diameter of lesions exceeds 1.5 cm, the diagnosis is highly suggestive of OB [4,5,6]. Malignant transformation in 12–25% of lesions has been described in the literature [7, 8]. Spinal OB most commonly affects the posterior aspects of the spine (laminae, pedicles, or spinous processes). Surgical resection is the main treatment method with high recurrence rates debated by the subtotal resection [10,11,12]. The effective treatment of spinal OB relies on precise diagnosis based on a crucial image. The radiographic features of OB can differ according to its location and type. Osteoblastoma (OB) is an intermediate lesion, which makes the accurate preoperative diagnosis very important. Osteoblastoma (OB) is an intermediate lesion, which makes the accurate preoperative diagnosis very important. 99mTc-methylene diphosphonate (99mTc-MDP) bone scan and SPECT/CT imaging were evaluated for their diagnostic value in spinal OB
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