3D computed tomography angiography as a novel post-processing approach in diagnosis of pediatric malignant bone tumors

Issue title: Multimedia Presentation Assisted Clinical Diagnosis, Prognosis and Treatment (II)

Guest editors: Yuanyuan ZhangDr.

Article type: Research Article

Authors: Wu, Jun^{a; 1} | Wang, Cui^{b; 1} | Li, Ming^{a; *} | Luo, Cong^{a; *} | Liu, Xing^a | Xie, Lina^a | He, Ling^b | Gong, Mengjia^c | Hu, Zujie^a | Bleyer, Anthony J.^d | Zhang, Yuanyuan^{e; *}

Affiliations: [a] Department of Orthopaedics Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China | [b] Department of Radiology Children’s Hospital of Chongqing Medical University, Chongqing, China | [c] Research Institute, Children’s Hospital of Chongqing Medical University, Chongqing, China | [d] Division of nephrology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA | [e] Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA

Correspondence: [*] Corresponding author: Ming Li and Cong Luo, Department of Orthopaedics Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China. E-mails: lm3180@163.com (Ming Li) and congluo@boneandcancer.org (Cong Luo). Yuanyuan Zhang, Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. E-mail: yzhang@wakehealth.edu.

Note: [1] The two joint first authors contributed equally.

Abstract: OBJECTIVE:This study aimed to investigate the application of 3D computed tomography (CT) angiography with a novel post-processing technique in diagnosis of malignant bone tumors in children. METHODS:Twenty-seven pediatric patients (15 males and 12 females; average age: 10±3.4 years old, with a range from 2 months to 14 years old) with suspected bone tumors were evaluated histopathologically using 3D CT angiography and a multislice scanner. CT angiography image data were analyzed with a novel post-processing technique that included separating, fusing opacifying false-coloring, and volume rendering. RESULTS:Among 27 cases, 20 (74%) osteosarcoma, 6 (22%) Ewing’s sarcoma, and 1 (4%) non-Hodgkin lymohoma were diagnosed by histological examination of surgical specimens. The tumor features, including size, location, invasion into the adjacent tissue as well as distant metastases, were clearly visualized with the regular volume rendering method and rotational and stereoscopical videos. The post-processing technique provided the reconstructed structure images without any overlap or shelter independently and collectively. Special colors represented different tissue structures, aiding in identification of various anatomical structures and pre-surgical planning. CONCLUSIONS:Compared to traditional 3-D CT methods, 3-D CT angiography with rotational and stereoscopical videos provides more detailed information of bone tumor lesions. It offers a superior and effective imaging technique in pediatric patients with malignant bone tumors.

Keywords: Malignant bone tumor, post-processing technique, computed tomography, angiography, imaging vivisection

DOI: 10.3233/XST-17346

Journal: Journal of X-Ray Science and Technology, vol. 26, no. 1, pp. 147-154, 2018