Diagnostic value of MRI signs in differentiating Ewing sarcoma from osteomyelitis

Omer Kasalak, Jelle Overbosch, Hugo J. A. Adams, Amelie Dammann, Rudi A. J. O. Dierckx, Paul C. Jutte, Thomas C. Kwee*

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

22 Citaten (Scopus)
397 Downloads (Pure)

Samenvatting

Background: The value of magnetic resonance imaging (MRI) signs in differentiating Ewing sarcoma from osteomyelitis has not be thoroughly investigated.

Purpose: To investigate the value of various MRI signs in differentiating Ewing sarcoma from osteomyelitis.

Material and Methods: Forty-one patients who underwent MRI because of a bone lesion of unknown nature with a differential diagnosis that included both Ewing sarcoma and osteomyelitis were included. Two observers assessed several MRI signs, including the transition zone of the bone lesion, the presence of a soft-tissue mass, intramedullary and extramedullary fat globules, and the penumbra sign.

Results: Diagnostic accuracies for discriminating Ewing sarcoma from osteomyelitis were 82.4% and 79.4% for the presence of a soft-tissue mass, and 64.7% and 58.8% for a sharp transition zone of the bone lesion, for readers 1 and 2 respectively. Inter-observer agreement with regard to the presence of a soft-tissue mass and the transition zone of the bone lesion were moderate (kappa = 0.470) and fair (kappa = 0.307), respectively. Areas under the receiver operating characteristic curve of the diameter of the soft-tissue mass (if present) were 0.829 and 0.833, for readers I and 2 respectively. Mean inter-observer difference in soft-tissue mass diameter measurement +/- limits of agreement was 35.0 +/- 75.0 mm. Diagnostic accuracies of all other MRI signs were all <50%.

Conclusion: Presence and size of a soft-tissue mass, and sharpness of the transition zone, are useful MRI signs to differentiate Ewing sarcoma from osteomyelitis, but inter-observer agreement is relatively low. Other MRI signs are of no value in this setting.

Originele taal-2English
Pagina's (van-tot)204-212
Aantal pagina's9
TijdschriftActa Radiologica
Volume60
Nummer van het tijdschrift2
DOI's
StatusPublished - feb.-2019

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