Diagnosis Of Bone Tumors Research Articles

Diagnostic value of SPECT/CT tomographic fusion imaging and magnetic resonance imaging in primary bone tumors

Objective To study the effects of single photon emission computed tomography/computed tomography (SPECT/CT) and magnetic resonance imaging (MRI) in the diagnosis of primary bone tumors. Methods A total of 104 patients with primary bone tumors in Zibo Central Hospital hospital from January 2016 to January 2018 were enrolled in this study. SPECT/CT and MRI examinations were performed on these patients, and the results of the examinations were compared with the results of surgical pathology. The diagnostic efficacy of the two methods for primary bone tumors were compared. Results ⑴Results of pathological examination: 70 cases were malignant tumors, and 34 cases were benign tumors; results of SPECT/CT: 72 cases were malignant tumors, and 32 cases were benign tumors; MRI: 76 cases were malignant tumors, and 28 cases were benign tumors; there was no difference between the two methods in the diagnosis of primary bone tumors. ⑵ The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SPECT/CT were 92.86%, 79.41%, 88.46%, 90.28% and 84.38% respectively, slightly higher than those of MRI (91.43%, 64.71%, 82.69%, 84.21% and 78.57%), but the difference was not statistically significant (P>0.05). ⑶ There was a high consistency between SPECT/CT and MRI in the diagnosis of primary bone tumors (Kappa value=0.613). ⑷ SPECT/CT is more accurate in the diagnosis of osteosarcoma, giant cell tumor, myeloma and fibrous dysplasia, while MRI is more accurate in the diagnosis of osteosarcoma, chordoma, Ewing's sarcoma and schwannoma. Conclusions SPECT/CT fusion imaging and MRI have high sensitivity and accuracy in the diagnosis of primary bone tumors, and the results of the two diagnostic methods have high consistency. SPECT/CT has a high accuracy in the diagnosis of ossification and calcification, while MRI has a high accuracy in the diagnosis of bone tumors in bone soft tissue and nervous system. Therefore, the joint application of the two methods can make up for each other's shortcomings and make the diagnosis of primary bone tumor more accurate. Key words: Tomography, emission-computed, single-photon; Magnetic resonance imaging; Bone neoplasms

A Study of Agreement between Histopathological and Clinico-Radiological Diagnosis of Bone Tumours and Tumour-like Lesions

A Study of Agreement between Histopathological and Clinico-Radiological Diagnosis of Bone Tumours and Tumour-like Lesions

Primary desmoplastic small round cell tumor of the tibia: PET/CT and MRI presentation of a rare case and review of the literature

Desmoplastic small round cell tumor (DSRCT) was a soft tissue sarcoma of mesenchymal cell origin that typically exhibited a multi-phenotypic pattern of immunohistochemical staining. DSRCT mainly presented in the abdomen sites and primary occurrence in bone was exceptional. In this study, we reported a new case of primary DSRCT of the tibia in a 33-year-old man who had intermittent pain in the left tibia. Radiographs showed transparent lesions in the left upper tibial. MRI revealed a lobular, lytic and ill-identified lesion with adjacent soft tissues swelling of the upper left tibia. CT confirmed notable destruction and wormlike osteolysis of the bone cortex. PET/CT showed a mass of high uptakes, indicating the malignance. He accepted surgical resection with followed multi-agent chemotherapy, containing vincristine, doxorubicin, ifosfamide and etoposide. Clinically and radiologically, the patient did not show any evidence of recurrence or metastasis at 30 months after surgical treatment. Primary osteogenic DSRCT was extremely rare and should be considered in differential diagnosis of bone tumors.

PET/CT-guided versus CT-guided percutaneous core biopsies in the diagnosis of bone tumors and tumor-like lesions: which is the better choice?

ObjectiveThe present study aimed to evaluate the diagnostic performance and safety of PET/CT-guided percutaneous core bone biopsy and to compare the PET/CT-guided method to conventional CT-guided percutaneous core biopsies to diagnose Chinese patients with bone tumors and tumor-like lesions.MethodsData for 97 patients with bone tumors and tumor-like lesions diagnosed by percutaneous core bone biopsy from February 2013 to November 2018 were retrospectively analyzed. The study included 42 cases in the PET/CT group and 55 cases in the CT alone group. The diagnostic performance, cost and complications associated with the intervention were compared between the two groups. All patients were eventually confirmed to have bone tumors and tumor-like lesions according to surgical pathology findings.ResultsThere were no significant differences in patient characteristics (P > 0.05). For the patients in the PET/CT group, the overall diagnostic yield of the initial biopsies and the diagnostic accuracy derived from the surgically proven cases were both 97.62%, which was significantly higher than the values in the CT group during the same period (P < 0.05). No major biopsy-related complications (e.g., serious bleeding or tumor dissemination) occurred before, during, or after the intervention. Therefore, no significant difference was observed between the two groups with regard to the complication rate (P > 0.05).ConclusionCompared with CT-guided percutaneous bone biopsy, PET/CT-guided percutaneous bone biopsy is an effective and safe alternative with high diagnostic performance in the evaluation of hypermetabolic bone lesions to diagnose bone tumors and tumor-like lesions.

Retrospective study of tumor and tumor like lesions of the bone-Tertiary center experience

Introduction: Bone tumors are important contributors for morbidity and mortality. Our hospital being, trauma and orthopedic institution, many orthopedic cases are referred to our center. We have done this study to determine the pattern of bone tumors, age and sex distribution, clinico pathological characteristics seen in our tertiary orthopedic Hospital. Materials and Methods: The study comprised of bone tumors diagnosed from January 2014 to December 2018 at Sanjay Gandhi Institute of Trauma & Orthopedics, Bangalore. Clinical and radiological details were collected from the data register. Microscopic findings were analyzed on Hematoxylin and eosin stained sections. Special stains and immunohistochemistry were done wherever essential. The bone tumors were classified based on WHO classification of bone tumors. Results: Of the 166 bone biopsies in a period of four years, 28 were malignant, 40 were benign and 14 were tumor like lesions. Most common age group was 11-20 years and were benign. Malignant tumors were common in 51-60 years age with male predominance and most of them were metastatic tumors. Conclusion: Diagnosis of bone tumors and treating them effectively reduces the morbidity and mortality as most of the tumors were benign and common in boys of younger age group. Correlation of clinico radiological features are essential for the conclusive histopathological diagnosis. This helps in planning the treatment and knowing the prognosis of the tumor. Keywords: Bone tumors, tumor like lesions, tertiary care hospital.

Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors.

Objective:To evaluate the role of diffusion-weighted MRI in differentiating benign from malignant primary bone tumors. To know the sensitivity and specificity of diffusion weighted MRI and calculating apparent diffusion coefficient (ADC) cutoff in differentiating benign from malignant primary bone tumors.Methods and materials :This is a prospective observational study of 50 patients, who were clinically or radiologically suspected with primary bone tumor and referred to the Department of Radiodiagnosis, for radiography or for MRI. These patients underwent routine MRI sequences including diffusion-weighted MRI with b-values of 0, 500 and 1000, followed by pathological examination supplemented by immunohistochemistry (wherever necessary). Hematological malignancies, recently biopsied cases and recurrent cases were excluded from the study.Results:Out of 50 patients with suspected bone tumors, 15 were benign (and tumor like lesions) and 35 were malignant primary bone tumors. The most common age group involved for both benign and malignant primary bone tumors was 11–20 years (23 cases—46%). In our study, total number of affected males were 27 (54%) and total number of affected females were 23 (46%) with M:F ratio of 1.17:1. In this study 72% lesions had appendicular bone involvement and 28% had axial bone involvement. 94.3% of malignant lesions showed restriction on diffusion-weighted imaging (DWI) and in 80 % of benign lesions restriction was absent on DWI which was statistically significant. Mean ADC levels in malignant lesions was 1.092 ± 0.497 and in benign lesions was 1.62 ± 0.596 which was statistically significant. Chondrosarcoma had highest ADC and Ewing’s sarcoma had lowest ADC values in malignant lesions. Chondroblastoma had highest ADC and Osteomyelitis had lowest ADC values in benign lesions. ADC value of 1.31 had highest sensitivity and specificity to differentiate between benign and malignant lesions.Conclusion:DWI is helpful in differentiating malignant from benign bone tumors and tumor like lesions with diffusion restriction favoring malignancy. Inspite of some overlap, ADC values of benign and malignant bone tumors are different and measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Calculation of ADC may also be used as baseline reference to assess response to treatment in future or for follow up.Advances in knowledge:DWI imaging (and ADC values) has been extensively used in neuroimaging. Extension of this application to musculoskeletal–oncologic imaging is not so well studied. Apart from differentiating benign from malignant lesions which is the main focus of this study, assessment of response to treatment by ADC values may be possible in near future.

Diagnostic efficacy of PET/CT in bone tumors.

Clinical value of PET/CT (positron emission tomography/computed tomography) in the diagnosis of malignant bone tumors (BT) was investigated. Fifty-four patients with BT were first diagnosed by ordinary CT and then by PET/CT. The diagnostic efficacy outcomes and diagnosis of malignant BT by clinical stage of the two methods for BT were observed and recorded, and the diagnostic value of PET/CT in the diagnosis of BT was evaluated. There were 14 cases of benign BT patients, 15 cases of stage I, 10 cases of stage II and 15 cases of stage III in malignant BT patients. The diagnostic coincidence rate of PET/CT was 92.59% and the diagnostic coincidence rate of CT was 72.22%, which showed that the diagnostic coincidence rate of PET/CT was significantly higher than that of CT (P<0.05). The sensitivity, negative predictive value and positive predictive value of PET/CT were 95.00, 85.71 and 95.00%, respectively, which were higher than those of CT (P<0.05). CT and PET/CT were used for the clinical staging and pathological diagnosis of malignant BT; the results showed that the diagnostic accuracy of PET/CT in the clinical stages of malignant BT was also significantly higher than that of CT (P<0.05). The diagnostic efficacy of PET/CT in BT is better than that in CT. PET/CT can diagnose the pathological properties of BT more accurately, and can also effectively diagnose the clinical stage of malignant BT and provide clinical diagnostic basis for follow-up procedures.

Intraosseous synovial sarcoma of the distal ulna: a case report and review of the literature

BackgroundSynovial sarcoma is a relatively rare type of soft tissue sarcoma. The commonly observed symptom is a deep-seated palpable mass accompanied by pain or tenderness. Thus, it is considered a soft tissue sarcoma and rarely occurs primarily in bone. However, only few studies have been reported on intraosseous synovial sarcoma, and reports on cases with cytogenetic or molecular confirmation are even rarer. We report a case of intraosseous synovial sarcoma of the distal ulna that has been confirmed using histopathological examination and molecular analysis.Case presentationA 77-year-old female was referred to our hospital with a 1-month history of right wrist pain after housework. Clinical and imaging findings suggested a benign bone tumor that was enhanced by Gd-DTPA. It was thought that the tumor was possibly an enchondroma. Initially, we planned to evaluate the benignancy of the tumor with intraoperative frozen section, followed by curettage and bone graft at one stage However, when considering carefully, characteristics of the tumor did not perfectly match those of any diagnostic categories including enchondroma. Therefore, an incisional biopsy was performed and revealed that the tumor was synovial sarcoma. Following an elaborate plan, the patient underwent a wide resection of the tumor at the distal part of the right ulna. Reverse transcription-polymerase chain reaction (RT-PCR) from the resected specimen and sequencing of RT-PCR products demonstrated a chimeric SYT-SSX1 transcript, confirming the diagnosis of synovial sarcoma.ConclusionsSynovial sarcoma is seldom considered in differential diagnosis of bone tumors because it is difficult to line up such an unusual diagnosis as a differential diagnosis. When the lesion does not perfectly fit into any diagnostic category, when the initial image diagnosis appears unconvincing, biopsy and pathology are indicated, recalling Jaffe’s triangle. According to these diagnostic processes, the patient successfully completed the treatment for this rare intraosseous synovial sarcoma, following a careful plan based on the preoperative diagnosis.

Multilobular Tumor of Bone in a Dog

Background: Multilobular tumor of bone (MTB) is a primary bone neoplasm, uncommon in dogs. This tumor was called of many names for a long time, as: chondroma rodens, multilobular osteochondrosarcoma, multilobular osteoma, multilobular chondroma, calcificating aponeurotic fibroma, although MTB was preferred chosen, because these other name could be correlated with humans’ tumors. This tumor is observed specially in skull bone, although it was reported in zygomatic arc, hard palate, axilla, spine and penis. Mostly happen in big breeds dogs, and middle to old age patients. Clinical signs depending of region and how aggressive the tumor is, usually are related to compression of any structure. The growth of MTB is frequently slow and progressive, locally invasive, occurring relapse after surgical revomal, although the tumor has low to moderate metastatic potential. The aim of this study is to report a case of MTB in a female dog and describe anatomopathological changes.Case: A female dog, mixed breed, 13 year-old, of middleweight was admitted in Pathology Department of College of Agricultural Sciences and Veterinary Medicine (FCAV-Unesp), Campus of Jaboticabal - SP, to be undergone to necropsy. The patient have never shown any epileptic crisis or neurologic signs. In macroscopic examination was found a mass in skull, which invaded the orbit and frontal sinus, but it was not invading brain cavity. The neoplasm had and irregular surface, firm consistent, color was white mixed to red areas, after cut it was granular and rough, and had some point mineralized areas. The lobs of lung had much firm masses, colored gray to white. In cytology it was observed fusiform to polyhedric isolated mesenchymal cells, moderated pleomorphic, basophilic cytoplasm, thin granulated nuclear chromatin, and visible nucleoli that was involved by eosinophilic extracellular matrix. The proposed diagnostic was bone sarcoma. Histopathological assessment showed mesenchymal neoplastic proliferation, and multilobular characteristic, the lobules had different sizes and was well organized, and they were separated by thin conjunctive septs. In the center of lobules, there was an “island” with mineralized or chondroitin bone matrix, in some of these islands there were osteoclast. The cells had moderated pleomorphism and low mitotic activity (three mitotic cells in ten high-power field). At least, it showed big necrosis areas and invasion of near tissue. In lung was observed metastatic areas, which had same histopathologic way of primary neoplasm in skull. That way, the histopathologic exam was similar to Multilobular tumor of bone grade II.Discussion: The MTB is an uncommon neoplasm, which assaults mostly skull bone in large breeds dogs and middle age of eight years old. This case accord to literature about breed size, age and local of tumor. The clinical signs in this dog was related to region what it was growing and near structure compression. Besides that, the patient had lung metastasis, that is the principal metastatic sites according to literature. The Histopathologic exam showed the same characters of MTB, which was considered grade II according to literature. Despite MTB is an uncommon neoplasm in clinic of dogs and cats, the epidemiological knowns as age, breed and localization, anatomopathological changes, and histopathological exam allows to have a diagnosis, showing the importance of including this neoplasm in differential diagnosis of bone tumor in dogs.

Correlación entre el diagnóstico imagenológico e histológico de tumores óseos. Un estudio retrospectivo

Introduction The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. Material and methods Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. Results Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesnt depreciate the value of bone biopsy in diagnosis of bone tumors. Conclusion This data showed good correlation between imagenological and histopatologic techniques.

Histomorphological Spectrum of Bone Tumors in A Tertiary Care Hospital

Background: Bone tumors are relatively uncommon, constituting only 0.5% of all types of cancer. Many bone tumor entities show a remarkable consistency in clinical presentation, age and anatomic site distribution. The final diagnosis of bone tumors should be based on an integrated use of histopathologic findings, clinical presentation, and imaging characteristics. Immunohistochemical and genetic/molecular techniques are at times crucial for the definite classification of certain bone tumors. Objective: The aim of the present study was to determine the spectrum, frequency and demographics of bone tumors at our institute Santokba Durlabhji Memorial Hospital, Jaipur. Materials and Method: A retrospective review of histopathological reports of all bone specimens received in the department of pathology (histopathology section) for a period of 3 years from January 2014 to January 2017 Results: On histopathological diagnosis, among neoplastic lesions incidence of benign tumors was 447 cases (60.4%), and malignant tumors was 293cases (39.6 %). Among the benign tumors, the most common benign tumor was Giant cell tumor 99 cases (13.3%). Osteosarcoma was commonest malignant tumor 42 cases (5.6%). Maximum number of bone tumors occurred in 15-45 years of age and the male to female ratio was 2:1 Conclusions: Bone tumors occurred predominantly within 15-45 years of age with a male preponderance. Giant cell tumor was the most common benign tumor, while Osteosarcoma was the most common malignant bone tumor. Femur is the most common site for bone tumors.

CT and MRI imaging of glomus tumors of the temporal bone

Glomus tumor is one of the most common temporal bone tumors. Most of them are benign and locally invasive, some are occasionally able to metastasize and have signs of malignancy. Diagnostic imaging is necessary before treatment. Computer tomography (CT) is traditionally used as a primary method of diagnosis, to recognize changes in the temporal bone. Role of magnetic resonance imaging (MRI) in temporal bone tumor diagnosis is not definitively determined.Purpose. To assess the possibilities of computer and magnetic resonance tomography, to develop an algorithm for the application of diagnostic imaging methods in the diagnosis of glomus tumors of the temporal bone.Material and methods. The article presents the experience of diagnosing 30 patients with glomus tumors.Results. The tympanic form of the glomus tumor was observed in 11 cases (37%), tympano-yugular in 19 cases (63%). CT and MRI data totally coincided in cases of small tumors (type A and B). In the presence of extended forms CT ability of assessing bone invasion, involvement of the internal carotid artery, internal jugular vein, and dural sinuses was lower than the MRI.

Conventional Radiography and MRI Diagnosis of Bone Tumors Developed at the Knee

Abstract Introduction. It is known that bone tumors have a predilection to develop for a certain skeletal bone segment. Also, bone tumors have a predilection for certain age groups. The knee is a common site for bone tumors. Purpose. Presentation of diagnostic parameters of conventional radiography as the first technique in the detection and characterization of bone tumors developed at the knee level and the criteria for differentiation of the malignant substrate from the benign (the type of bone destruction, the type of periosteal response, poorly defined margins) one. The value of MRI is also presented and illustrated as a unique imaging technique that allows the direct visualization of bone marrow with high spatial resolution for local staging of bone tumors. Material and method. The present study aimed to investigate the radiographic and MRI imaging characteristics of bone tumors developed at the knee joint, which were retrospectively analyzed (October 2007 and November 2017) in a selected group of 91 patients. The limit of age between 11 and 67 years, 73(70%) men, 18 (30%) women. Examination protocol: complete clinical examination, radiographic knee examination in anteroposterior and lateral incidents. MRI standard protocol, native, and post paramagnetic contrast. Results. Conventional Radiographic and MRI have been detected and characterized a number of 55 (67%) primary malignant bone tumors confirmed by histopathological diagnosis, ranging from 8 histopathological types and 37 (33%) cases of benign tumors with 9 histopathological types. Conclusions. Radiological examination is the first investigation in the evaluation of knee bone tumors, suggesting the malignant nature expressed by the badly defined margin, bone destruction, discontinuous peristaltic reaction, and extension to the soft parts. MRI is a unique imaging technique that allows direct visualization of bone marrow with high spatial resolution and best tool for local staging of bone tumors.

Study of Bone Tumors in a Tertiary Care Hospital of Dhaka City

Background: The wide spectrum of bone tumors, their rarity, diverse origin and tendency to produce overlapping anatomic patterns pose a definite diagnostic challenge to the orthopedic surgeons and the pathologists.Objective: The present study was intended to find the pattern of bone tumors and their anatomical locations, and histopathological characteristics in a tertiary care hospital of Dhaka.Methodology: A retrospective review of the histopathological records of patients with established diagnosis of bone tumors at National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh was done from January 2015 to December 2016 for a period of two (02) years. The demographic data such as the age and sex, anatomical location and histopathological findings were studied from the existing records of the patients and their slides were reexamined. Bone lesions of inflammatory origin were excluded from this study leaving the lesions of both neoplastic and tumor-like origin for further study.Result: A total 283 cases of bone lesions were primarily included in the study. Bone lesions of inflammatory origin (n = 65) were excluded from this study leaving 218 lesions of both neoplastic and tumor-like origin for further study. The median age of the patients was 22 (range: 3 – 75) years. In terms of anatomical site of the tumors, over one-third (36.6%) was located in femur 21.1% in tibia, 12.2% in humerus, 6.1% in radius and 5.6% in ulna. In terms of types of bone tumor, 105(48.2%) were benign, 66(30.3%) malignant, 47(21.5%) tumor-like lesions. About 65% of the benign tumors were of Giant cell tumor, 28.5% were osteochondroma, 1% osteoma and 5.7% were of other types. Of the malignant tumors, one-third (33.3%) was of metastatic type, 27.3% Ewing’s sarcoma, 22.7% osteosarcoma, 9.1% chondrosarcoma and 4.6% were of other varieties.Conclusion: Primary bone tumors are mainly benign; however, giant cell and metastatic tumors are the most common benign and malignant bone tumors respectively.Journal of Current and Advance Medical Research 2018;5(1):23-28

Epidemiological characteristics of patients with pelvic tumors submitted to surgical treatment

ObjectiveDescribe the epidemiological profile of patients with primary or secondary neoplastic lesions in the pelvis who required a surgical procedure such as hemipelvectomy. MethodsThis study retrospectively evaluated 69 patients located in the database of a São Paulo educational institution, subject to surgical hemipelvectomy treatment between January 1990 and December 2013. All patients had previous diagnosis of bone tumor (primary or metastatic) in the pelvis (ilium, ischium, pubis, and/or sacrum). ResultsAnalyzing the data obtained in this study, it was observed that these are partly similar to those found in the literature, with primary bone malignancies as the main diagnosis; general injuries affecting the pelvic area I (pelvic bone) and its most frequent complication, infection. The differences are mainly due to rarity of the bone tumors evaluated in this study, and the type of surgical procedure in question, which is even more unusual. ConclusionBuilding a picture that conveys the reality of each diagnosis and that indicates which characteristics of these patients would better resemble an absolute or relative indication for the realization of hemipelvectomy is harder by the rarity of these cases.

Real-time in vivo imaging of metastatic bone tumors with a targeted near-infrared fluorophore.

Tumors of the prostate or breast are particularly likely to metastasize to the bone, and early diagnosis of metastatic bone tumors is important for designing an effective treatment strategy. Imaging modalities for the detection of bone metastasis are limited, and radiation-based techniques are commonly used. Here, we investigated the efficacy of selective near-infrared (NIR) fluorescence detection of metastatic bone tumors and its role in the detection of bone metastasis in prostate and breast cancer cell lines and in a xenograft mouse model. A targeted NIR fluorophore was used to monitor metastatic bone tumors using a NIR fluorescence imaging system in real time, enabling the diagnosis of bone metastasis in vivo by providing the location of the metastatic bone tumor. The NIR fluorescence imaging technique using targeted NIR contrast agents is a potential tool for the early diagnosis of bone tumors.

Bone Tumor Diagnosis Using a Naïve Bayesian Model of Demographic and Radiographic Features.

Because many bone tumors have a variety of appearances and are uncommon, few radiologists develop sufficient expertise to guide optimal management. Bayesian inference can guide decision-making by computing probabilities of multiple diagnoses to generate a differential. We built and validated a naïve Bayes machine (NBM) that processes 18 demographic and radiographic features. We reviewed over 1664 analog radiographic cases of bone tumors and selected 811 cases (66 diagnoses) for annotation using a quantitative imaging platform. Leave-one-out cross validation was performed. Primary accuracy was defined as the correct pathological diagnosis as the top machine prediction. Differential accuracy was defined as whether the correct pathological diagnosis was within the top three predictions. For the 29 most common diagnoses (710 cases), primary accuracy was 44%, and differential accuracy was 60%. For the top 10 most common diagnoses (478 cases), primary accuracy was 62%, and differential accuracy was 80%. The machine returned relevant diagnoses for the majority of unknown test cases and may be a feasible alternative to machine learning approaches such as deep neural networks or support vector machines that typically require larger training data (our model required a minimum of five samples per diagnosis) and are "black boxes" (our model can provide details of probability calculations to identify features that most significantly contribute to truth diagnoses). Finally, our Bayes model was designed to scale and "learn" from external data, enabling incorporation of outside knowledge such as Dahlin's Bone Tumors, a reference of anatomic and demographic statistics of more than 10,000 tumors.

A retrospective analysis of computed tomography guided biopsy in the diagnosis of primary bone tumors

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Primary bone tumors account for a small yet significant number in the total incidence of tumors. Computed tomography (CT) guided percutaneous core biopsy is a novel yet significant step in the approach towards the diagnosis of bone tumors and is increasingly performed by orthopaedic oncologists around the world. This study is aimed to evaluate the diagnostic accuracy of CT guided biopsy in the diagnosis of primary bone tumors. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients who underwent CT guided biopsy and subsequent excision for primary bone tumors from January 2008 to July 2015 were analysed. CT guided biopsy results were compared with post-operative histopathological reports to evaluate its sensitivity and specificity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 161 patients were included in the retrospective study. Among them, 147 were true positives, 7 were false negatives, 6 were true negatives and one was false positive. The sensitivity of CT guided biopsy in the diagnosis of primary bone tumor was 95.4 % with specificity of 85.7% with a diagnostic efficiency of 90.5%. The complication rate was 4.3%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; CT guided biopsy is a safe, simple and effective procedure to rule out and rule in the diagnosis of primary bone tumors.&lt;/p&gt;

Características epidemiológicas dos pacientes com tumores pélvicos submetidos a tratamento cirúrgico

ObjectiveDescribe the epidemiological profile of patients with primary or secondary neoplastic lesions in the pelvis who required a surgical procedure such as hemipelvectomy. MethodsThis study retrospectively evaluated 69 patients located in the database of a São Paulo educational institution, subject to surgical hemipelvectomy treatment between January 1990 and December 2013. All patients had previous diagnosis of bone tumor (primary or metastatic) in the pelvis (ilium, ischium, pubis, and/or sacrum). ResultsAnalyzing the data obtained in this study, it was observed that these are partly similar to those found in the literature, with primary bone malignancies as the main diagnosis; general injuries affecting the pelvic area I (pelvic bone) and its most frequent complication, infection. The differences are mainly due to rarity of the bone tumors evaluated in this study, and the type of surgical procedure in question, which is even more unusual. ConclusionBuilding a picture that conveys the reality of each diagnosis and that indicates which characteristics of these patients would better resemble an absolute or relative indication for the realization of hemipelvectomy is harder by the rarity of these cases.

Utility of FNAC in the Diagnosis of Bone Tumors

Utility of FNAC in the Diagnosis of Bone Tumors