AI Article Synopsis
- The study investigates the effectiveness of gadolinium-enhanced MRI in planning surgeries for patients with extremity osteosarcoma, specifically looking at neurovascular bundle involvement (NBI) and intraarticular extension (IAE).
- Two pediatric radiologists analyzed MRI scans from 56 patients, finding high agreement in identifying NBI and IAE before and after contrast administration, with Kappa values indicating strong consistency.
- The results suggest that non-contrast MRI may be adequate for surgical planning in pediatric osteosarcoma cases, as no significant differences were found between pre- and post-contrast interpretations.
Article Abstract
Background And Objectives: The value of gadolinium enhanced magnetic resonance imaging (MRI) sequences for extremity osteosarcoma resection planning is unverified. We evaluate the performance of intravenous gadolinium enhanced MRI for identification of neurovascular bundle involvement (NBI) and intraarticular extension (IAE) in patients with osteosarcoma.
Methods: Two pediatric radiologists independently analyzed MRI examinations of patients with pathology proven extremity osteosarcoma for NBI and IAE. Initial evaluation utilized only non-contrast MRI images (PRE) and, after 2 weeks, subsequent evaluation included both the pre and post contrast images (POST). Cohen's Kappa and McNemar's test were calculated to assess agreement between PRE and POST image interpretations of NBI and IAE.
Results: 56 patients with 90 preoperative MRI examinations were analyzed. PRE and POST interpretations were rarely discordant; 4/90 cases for NBI (Kappa 0.91) and 2/90 cases for IAE (Kappa 0.95). McNemar's test did not show a difference between PRE and POST imaging (NBI p=0.62; IAE p=0.48).
Conclusion: No significant difference between PRE and POST image interpretation was found. A high level of agreement between PRE and POST image interpretation suggests that pre-contrast MRI may be sufficient for pre-surgical planning for pediatric patients with long bone osteosarcoma.
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| http://dx.doi.org/10.1016/j.suronc.2018.11.018 | DOI Listing |
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