Radiological findings of denosumab treatment for giant cell tumours of bone
Giant cell tumours of bone (GCTB) are benign giant cell-rich tumours typically occurring in the epi-metaphysis of skeletally mature patients. Despite their benign classification, GCTB may be locally aggressive with local recurrence as a challenging issue. Denosumab is a human monoclonal antibody that inhibits osteolysis via the RANK-RANK ligand pathway. There is currently no consensus on optimal treatment duration or imaging modality for monitoring patients on denosumab therapy. This review illustrates the radiological findings of GCTB on denosumab treatment seen on plain radiographs, CT, MRI, PET-CT and DEXA, with reference to the current literature. Recognizing imaging features indicative of a positive response to denosumab is important for therapeutic decision-making. Imaging findings with respect to duration of denosumab treatment, tumour upregulation during treatment, tumour recurrence and malignant transformation are discussed. The development of a sclerotic neocortex and varying degrees of matrix osteosclerosis are seen on plain radiographs. Reconstitution of subarticular bone and articular surface irregularity are optimally evaluated on CT which can also quantify tumour density. MRI demonstrates heterogeneous low signal matrix and is useful to assess decrease in size of cystic and/or soft tissue components of GCTB. A fat-suppressed fluid-sensitive MR sequence is important to detect tumour reactivation. Reduction in 18F-FDG-PET avidity represents an early sensitive sign of response to denosumab treatment. Regardless of imaging modality, close follow-up in a specialist centre and careful evaluation of nonresponders is necessary as local recurrence after cessation of denosumab treatment and malignant transformation of GCTB have been described.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
|---|---|
| Enthalten in: |
Skeletal radiology - 49(2020), 9 vom: 01. Sept., Seite 1345-1358 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van Langevelde, Kirsten [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
4EQZ6YO2HI |
|---|
| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 24.06.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00256-020-03449-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM309198100 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM309198100 | ||
| 003 | DE-627 | ||
| 005 | 20231225133401.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00256-020-03449-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1030.xml |
| 035 | |a (DE-627)NLM309198100 | ||
| 035 | |a (NLM)32335707 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van Langevelde, Kirsten |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Radiological findings of denosumab treatment for giant cell tumours of bone |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.06.2021 | ||
| 500 | |a Date Revised 24.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Giant cell tumours of bone (GCTB) are benign giant cell-rich tumours typically occurring in the epi-metaphysis of skeletally mature patients. Despite their benign classification, GCTB may be locally aggressive with local recurrence as a challenging issue. Denosumab is a human monoclonal antibody that inhibits osteolysis via the RANK-RANK ligand pathway. There is currently no consensus on optimal treatment duration or imaging modality for monitoring patients on denosumab therapy. This review illustrates the radiological findings of GCTB on denosumab treatment seen on plain radiographs, CT, MRI, PET-CT and DEXA, with reference to the current literature. Recognizing imaging features indicative of a positive response to denosumab is important for therapeutic decision-making. Imaging findings with respect to duration of denosumab treatment, tumour upregulation during treatment, tumour recurrence and malignant transformation are discussed. The development of a sclerotic neocortex and varying degrees of matrix osteosclerosis are seen on plain radiographs. Reconstitution of subarticular bone and articular surface irregularity are optimally evaluated on CT which can also quantify tumour density. MRI demonstrates heterogeneous low signal matrix and is useful to assess decrease in size of cystic and/or soft tissue components of GCTB. A fat-suppressed fluid-sensitive MR sequence is important to detect tumour reactivation. Reduction in 18F-FDG-PET avidity represents an early sensitive sign of response to denosumab treatment. Regardless of imaging modality, close follow-up in a specialist centre and careful evaluation of nonresponders is necessary as local recurrence after cessation of denosumab treatment and malignant transformation of GCTB have been described | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a CT | |
| 650 | 4 | |a Denosumab | |
| 650 | 4 | |a Giant cell tumour of bone | |
| 650 | 4 | |a Imaging | |
| 650 | 4 | |a MRI | |
| 650 | 4 | |a PET-CT | |
| 650 | 7 | |a Bone Density Conservation Agents |2 NLM | |
| 650 | 7 | |a Denosumab |2 NLM | |
| 650 | 7 | |a 4EQZ6YO2HI |2 NLM | |
| 700 | 1 | |a McCarthy, Catherine L |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Skeletal radiology |d 1993 |g 49(2020), 9 vom: 01. Sept., Seite 1345-1358 |w (DE-627)NLM001182935 |x 1432-2161 |7 nnns |
| 773 | 1 | 8 | |g volume:49 |g year:2020 |g number:9 |g day:01 |g month:09 |g pages:1345-1358 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00256-020-03449-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 49 |j 2020 |e 9 |b 01 |c 09 |h 1345-1358 | ||