Magnetic Resonance Imaging of Bone and Soft Tissue Tumors and Their Mimics: A Clinical Atlas

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Ghazinoor et al. In order to determine the potential of low-field MRI as an alternative, its precision in measuring position of implant and bone must be calculated. The precision of low-field MRI for measuring zero motion depends partly on the imaging technique and partly on the analysis process, which consists of segmentation and registration. It is important to quantify the precision of low-field MRI first, since this is prerequisite before implementing the method in clinical practice.

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Segmentation can be performed manually or semi- automatically and provides 3D models to be used in subsequent registration steps. In order to calculate prosthetic migration, model matching which is called registration between 3D models is necessary. An accurate, fully automatic segmentation and registration procedure is more standardized and time-effective than manual registration.

However, manual registration may be more precise and visual feed-back can be interpreted while performing the segmentations steps. In order to determine which registration method is most suitable three methods: manual, semi-automatic with the use of 3D reference models and semi-automatic without the use of 3D reference models were compared. The primary goal of this study was to assess the feasibility to use low-field 0. Additionally, the type of registration method most suitable for measuring the position of the tibial component was assessed.

The aim of the following study was to determine the feasibility of low-field MRI to measure the precision of zero motion, several steps were taken Fig. Memphis USA with respect to the surrounding bone, 3D geometrical models of both the prosthesis and the bone were made. The study focused on the tibial component of a total knee arthroplasty because according to the Swedish arthroplasty register their failure of the tibial component 6. Robertsson Otto et al. The 3D model of the porcine tibial bone was created by scanning the bone without containing the implant on a low-field MRI 0. In order to obtain the 3D surface model of the bone, an imaging expert semi-automatically segmented the cortical bone of both the tibia and fibula with Mimics Mimics Research Gelatine was chosen for its properties such as relaxation time and elasticity in order to mimic the soft tissue of the knee.

Madsen et al. In this phantom study, it was ensured that the prosthesis did not migrate with respect to the surrounding bone zero motion during the various scanning sessions. The phantom was relocated 12 times, the relocation varied between maximal 25 degrees rotation left and right from the supine position.

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The differences in translation and rotations of the tibial plate with respect to the position of the bone measured across the 12 acquisitions were defined as the precision of zero-motion for low-field MRI. This particular sequence was chosen because it reduces metal artefacts, provides good contrast between bone and surrounding soft tissue, and is capable of adequately imaging the human knee. During all acquisitions, the temperatures of the room and the phantom were kept constant 21 degrees Centigrade. The segmentations included the following steps:.

The segmentation models of the bone and prosthesis were registered to the 3D reference models constructed earlier.

Registration was performed to transform all segmented datasets into the reference coordinate system in order to facilitate future calculations. Registration was performed in three different ways in order to determine which method is most accurate. The three methods are described below. Marker-free MRI manual registration MMRI-M : The segmentation of the bone was registered to the 3D reference model of the bone with the automatic registration algorithm available in Mimics global registration followed by local registration.

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Clinical Manifestations and Diagnosis of Malignant Tumors in Children

Several landmarks of the prosthetic model, e. Marker-free MRI automatic registration, fully automatic registration with the use of 3D reference models MMRI-A : The automatic registration algorithm available in Mimics was used to register the prosthetic and bone segmentations to the 3D reference models of the prosthetic and the bone. Marker-free MRI automatic registration, fully automatic without the use of 3D reference models MMRI-W : The segmentations of the prosthesis and the bone based on the MRI scans of acquisition number one were taken as a reference model instead of the 3D reference models.

Using the automatic registration algorithm available in Mimics, these were registered to the segmentations of the prosthesis and bone based on the remaining acquisitions. During registration, all 3D segmentations were matched to a 3D reference model and transformed to the reference coordinate system. Results are presented for all three registration methods. In order to compare the different registration algorithms, three distance plot presenting the migration of the tibial component calculated par point were compiled.


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The boxplots also visualize the current golden standard, i. Of the three registration methods, MMRI-M measured the precision of zero motion most precise, with a maximal mean error of 0. External internal migration was fully within the range considered clinically relevant. In this figure, the difference between the calculated value error and the real migration zero is visualized on the surface of the tibial component. The smallest error was seen in the distal part of the stem of the tibial component.


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Of the proximal plate, the posterior area had the smallest error. Distance plots for translation of the prosthesis with respect to the bone for the three types of registration methods used. The boxplots in Fig. As is evident, the results are mostly out of range for all degrees of freedom, regardless of the registration method used. The distal-proximal direction shows the largest translation error. The dashed horizontal lines indicate bounding range of RSA accuracy reported in literature.

The most important finding of the present study is that the low-field MRI method as utilized in this study is not yet as precise as the golden standard RSA. The values for the precision of zero motion for rotation are more precise than those in recent marker-free RSA studies from Seehaus et al. Seehaus et al.

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In this study, the largest measurement error for translation is in the distal-proximal direction. An improvement in the through-plane resolution is expected to result in a more detailed segmentation and thereby to contribute to a smaller standard deviation for translation. Fundamentals of skeletal radiology. Philadelphia: Elsevier, ; p Anderson J, Read J. Atlas of imaging in sports medicine. New York: McGraw Hill, ; p. Bianchi S, Martinoli C. Ultrasound of the musculoskeletal system. New York: Springer, ; p. MR imaging of myositis ossificans: Variable patterns at different stages.

J Magn Reson Imaging. Musculoskeletal imaging: The requisites. Philadelphia: Elsevier, ; p. Shock waves in the treatment of post-traumatic myositis ossificans.

Ultrasound Med Biol. South African Journal of Radiology. Login Register. Article Tools Abstract. Print this article. How to cite item. Finding References. Email this article Login required. Email the author Login required. J Pediatr Orthop — Acta Orthop Scand 81—83 Wilkinson RH : Osteoid osteoma. Postgrad Med 61—62 Yamamura S Sato K Sugiura H et al : Prostaglandin levels of primary bone tumor tissues correlate with peritumoral edema demonstrated by magnetic resonance imaging. Cancer 79 : — Yamamura S Sato K Sugiura H et al: Prostaglandin levels of primary bone tumor tissues correlate with peritumoral edema demonstrated by magnetic resonance imaging.

Cancer — User Account Sign in to save searches and organize your favorite content. Not registered? Sign up My Content 1 Recently viewed 1 Vertebral osteoid oste Search Close Advanced Search Help. Vertebral osteoid osteoma associated with paravertebral soft-tissue changes on magnetic resonance imaging Report of two cases. Restricted access. All currencies in US Dollar. Rhoton Anatomy Links. Article Information. Keywords: osteoid osteoma ; spinal tumor ; magnetic resonance imaging ; soft tissue ; pediatric neurosurgery Page Count: — Case Reports Case 1 Case 2 Discussion.

View in gallery Case 1. View in gallery Case 2. View in gallery Photomicrograph showing the nidus composed of immature partially calcified osteoid in a fibrovascular tissue stroma. View raw image Close. Skeletal Radiol 37—41, false.


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