IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:70
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013,      India [Click for Full details]  

Authors: Dev C, Rastogi S, Jagannathan N R, Gamanagatt S, Safaya R

Authors Affiliations:

Address of correspondence: cdpannu@gmail.com

 

Abstract                                                                                                                 

Introduction: Choline assessment in MR spectroscopy is useful investigation in various tumors. However its role in bone tumors especially giant cell tumors is not well defined. This study was conducted to evaluate whether the presence of choline peak correlates with the recurrence and aggressiveness of GCT.

Methodology: 31 cases of recurrent GCT were recruited in prospective cohort study conducted in the Department of Orthopedics, AIIMS from November 2010 to October 2012. Patients were evaluated clinically and radiologicaly. Campanacci grading and Enneking staging system were used. Only Grade II and Grade III tumours were included. MRI evaluation included conventional and dynamic contrast enhanced sequences. Assessment of dynamic MRI was done as described by Shah et al (2007). In vivo Proton MRS was done using single voxel point-resolved spectroscopy sequence (2,000/30, 2,000/135, 2,000/270). Choline was considered positive if definite peak at 3.2 ppm is present in at least one of the spectra.

Results:Out of 31 patients 18 were recurrent GCT and 13 were aggressive GCT. 19 were females and 12 were males. Most common affected site was distal end femur. Out of 15 recurrent GCT in which study was completed, choline was positive in all. 11 Patients had Type I, 3 Patients had Type II curve and dynamic MRI was not done in 1 patient. Out of 12 aggressive GCT, choline was positive in 11 and absent in 1.5 Patients had Type I , 4 had Type II and 2 had Type III curves on Dynamic MRI.

Discussion: This study has confirmed that Choline is a reliable marker of aggressiveness and recurrence in GCT. Raised choline concentration in GCT is more specific marker of aggressiveness than type 1 curve and helpful in estimating the prognosis in advance which may have bearing on treatment.

How to Cite this Abstract
Dev C, Rastogi S, Jagannathan N R, Gamanagatt S, Safaya R . Role of NMR spectroscopy in recurrent and aggressive GCT. International Journal of Conference Proceedings 2015;(2015):70