MRI of diffuse-type tenosynovial giant cell tumour in the knee: a guide for diagnosis and treatment response assessment

Insights into Imaging

Educational Review

Hans Gelderblom¹  Michiel A. J. van de Sande²  Geert Spierenburg²  Carlos Suevos Ballesteros³  Ana Navas Cañete⁴  Kirsten van Langevelde⁴  Berend C. Stoel⁵ 

[1] Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands;Department of Orthopaedic Surgery, Leiden University Medical Centre, PO Box 9600, Postzone J11-R-70, 2300 RC, Leiden, The Netherlands;Department of Radiology, Hospital Universitario Ramón y Cajal, Madrid, Spain;Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands;Division of Image Processing, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands;

关键词: Tenosynovial giant cell tumour;    Diffuse-type TGCT;    Magnetic resonance imaging;    Colony-stimulating factor 1;    3D segmentation;   

DOI  :  10.1186/s13244-023-01367-z

 received in 2022-08-10, accepted in 2023-01-03,  发布年份 2023

来源: Springer

【 摘 要 】

Tenosynovial giant cell tumour (TGCT) is a rare soft-tissue tumour originating from synovial lining of joints, bursae and tendon sheaths. The tumour comprises two subtypes: the localised-type (L-TGCT) is characterised by a single, well-defined lesion, whereas the diffuse-type (D-TGCT) consists of multiple lesions without clear margins. D-TGCT was previously known as pigmented villonodular synovitis. Although benign, TGCT can behave locally aggressive, especially the diffuse-type. Magnetic resonance imaging (MRI) is the modality of choice to diagnose TGCT and discriminate between subtypes. MRI can also provide a preoperative map before synovectomy, the mainstay of treatment. Finally, since the arrival of colony-stimulating factor 1-receptor inhibitors, a novel systemic therapy for D-TGCT patients with relapsed or inoperable disease, MRI is key in assessing treatment response. As recurrence after treatment of D-TGCT occurs more often than in L-TGCT, follow-up imaging plays an important role in D-TGCT. Reading follow-up MRIs of these diffuse synovial tumours may be a daunting task. Therefore, this educational review focuses on MRI findings in D-TGCT of the knee, which represents the most involved joint site (approximately 70% of patients). We aim to provide a systematic approach to assess the knee synovial recesses, highlight D-TGCT imaging findings, and combine these into a structured report. In addition, differential diagnoses mimicking D-TGCT, potential pitfalls and evaluation of tumour response following systemic therapies are discussed. Finally, we propose automated volumetric quantification of D-TGCT as the next step in quantitative treatment response assessment as an alternative to current radiological assessment criteria.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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