Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK.
Skeletal Radiol. 2012 Apr;41(4):429-36. doi: 10.1007/s00256-011-1252-x. Epub 2011 Sep 3.
To assess the value of whole-body bone scintigraphy in the initial surgical staging of chondrosarcoma of bone.
A retrospective review was conducted of the bone scintigraphy reports of a large series of patients with peripheral or central chondrosarcoma of bone treated in a specialist orthopaedic oncology unit over a 13-year period. Abnormal findings were correlated against other imaging, histological grade and the impact on surgical staging.
A total of 195 chondrosarcomas were identified in 188 patients. In 120 (63.8%) patients the reports of bone scintigraphy noted increased activity at the site of one or more chondrosarcomas. In one patient the tumour was outside the field-of-view of the scan, and in the remaining 67 (35.6%) cases, there was increased activity at the site of the chondrosarcoma and further abnormal activity in other areas of the skeleton. Causes of these additional areas of activity included degenerative joint disease, Paget's disease and in one case a previously undiagnosed melanoma metastasis. No cases of skeletal metastases from the chondrosarcoma were found in this series. Multifocal chondrosarcomas were identified in three cases. In two it was considered that all the tumours would have been adequately revealed on the initial MR imaging staging studies. In only the third multifocal case was an unsuspected, further presumed low-grade, central chondrosarcoma identified in the opposite asymptomatic femur. Although this case revealed an unexpected finding the impact on surgical staging was limited as it was decided to employ a watch-and-wait policy for this tumour.
There is little role for the routine use of whole-body bone scintigraphy in the initial surgical staging in patients with chondrosarcoma of bone irrespective of the histological grade.
评估全身骨闪烁显像术在骨软骨肉瘤初始外科分期中的价值。
对 13 年来在一家骨科肿瘤专科治疗的一组外周或中央骨软骨肉瘤患者的全身骨闪烁显像报告进行回顾性分析。将异常发现与其他影像学、组织学分级和对手术分期的影响进行对比。
在 188 例患者中共发现 195 例软骨肉瘤。在 120 例（63.8%）患者的全身骨闪烁显像报告中，在一处或多处软骨肉瘤部位发现有放射性增加。在 1 例患者中，肿瘤位于扫描视野之外，在其余 67 例（35.6%）患者中，在软骨肉瘤部位有放射性增加，并且在骨骼的其他部位也有异常放射性增加。这些额外放射性增加的原因包括退行性关节病、佩吉特病和在 1 例病例中为先前未诊断的黑色素瘤转移。在本系列中未发现软骨肉瘤的骨转移病例。在 3 例患者中发现多灶性软骨肉瘤。在 2 例中，认为所有肿瘤都可以在初始的 MR 成像分期研究中充分显示。仅在第 3 例多灶性病例中，在对侧无症状股骨中发现了一个未预料到的、进一步推测为低度、中央性软骨肉瘤。尽管该病例揭示了一个意外的发现，但对手术分期的影响有限，因为决定对该肿瘤采用观望政策。
无论组织学分级如何，全身骨闪烁显像术在骨软骨肉瘤患者的初始外科分期中常规应用的价值不大。
