Magnetic Resonance Spectroscopy of Giant Cell Tumour of Bone TC07-TC10
Dr. Chetana Ramesh Ratnaparkhi,
Plot No 82, New Indira Colony Bhagwan Nagar, Nagpur-440027, Maharashtra, India.
Introduction: Usefulness of proton Magnetic Resonance Spectroscopy (MRS) in evaluating and differentiating benign from malignant bone tumours is well known and has been reported in literature. Role of magnetic resonance spectroscopy in Giant Cell Tumour (GCT) of bone is still not well established.
Aim: To evaluate the magnetic resonance spectroscopy features of GCT and to assess whether choline is a frequent occurrence in these tumours and whether magnetic resonance spectroscopy appearance can be correlated with clinical, radiological and histopathological findings.
Materials and Methods: Ten patients with suspected GCT of bone based on clinical history and radiograph were subjected to Magnetic Resonance Imaging (MRI) and multivoxel magnetic resonance spectroscopy on 1.5T MR machine. On the basis of magnetic resonance spectroscopy findings, patients were grouped into two categories, one with demonstrable choline peak and another without choline peak. Clinical and radiological findings viz., are Campanacci grading and magnetic resonance imaging features were compared in these two groups. Preoperative histopathology was done in all patients. All underwent operative procedures and postoperative histopathology was also done.
Results: All 10 patients in present study belonged to Campanacci Grade III i.e., showing aggressive radiographic appearance. Out of these 10 patients, only four showed elevated choline level (40%). Soft tissue component was seen in one patient and cystic component was seen in three patients showing choline peak. Fluid-fluid levels were seen in only one patient with demonstrable choline peak. On histopathology all of them turned out to be benign.
Conclusion: This study indicates that even if GCT of bone showed elevated choline level on magnetic resonance spectroscopy, it is not a predictor of malignant transformation. There is no linear correlation between aggressive radiological features and occurrence of choline peak.