Osteoarticular Tumor Characterization by Advanced Imaging

Study Overview
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Brief Summary
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The purpose is to compare and evaluate multiple functional imaging methods (perfusion, diffusion, spectroscopy) for initial benign/malignant characterization of osteoarticular tumors and to determine which method or which association of methods could improve non invasive tissue characterization. Secondary purposes are: to determine a possible correlation between some parameters and the histological grade (FNCLCC) to suggest a coherent diagnostic imaging approach for osteoarticular tumors. The ancillary study will enroll patients needing radiological tumor follow-up. The purpose is to identify tools for evaluation of tumor activity and therapeutic response before modification of morpho-volumetric data.

Detailed Description
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Patients refered for the initial evaluation of suspected osteoarticular masses will be included in this study after signing an informed consent. Histologic analysis will be used as a gold standard. The following imaging techniques will be evaluated: contrast enhanced ultrasonography Low dose CT perfusion Magnetic resonance perfusion Diffusion weighted imaging Magnetic resonance proton spectroscopy

Official Title
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Osteoarticular Tumor Characterization by Advanced Imaging

Conditions
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Bone Tumor, Soft Tissue Tumor

Intervention / Treatment
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* Other: Ecography
* Other: CT scan
* Other: MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients examined for initial assessment of bone or peripheral soft-tissue primitive tumor patients with normal awareness level patients having signed informed consent Exclusion Criteria: pregnant women persons deprived of liberty persons under legal protection or unable to give informed consent persons in life-threatening emergency allergy to Sonovue, iodinated contrast media or gadolinium chelates risk of pregnancy breastfeeding women acute coronary syndrome or unstable ischemic cardiopathy (ban on injection of contrast agent for CT scan) renal failure (ban on injection of contrast agent for MRI and CT scan) contraindication to MRI

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with bone or peripheral soft-tissue tumor<br> | Other: Ecography<br>* Standard Doppler ultrasound and perfusion imaging after injection of Sonovue<br>Other: CT scan<br>* With injection of Iomeron 400<br>Other: MRI<br>* With injection of gadolinium (Multihance)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contrast enhancement in echography: yes or no |  | baseline | 
| Contrast enhancement curve (absent, slow or fast) in echography |  | baseline | 
| Maximal intensity of enhancement peak in echography |  | baseline | 
| Mean transit time of enhancement in echography |  | baseline | 
| Gradient of contrast enhancement curve in echography |  | baseline | 
| Vascularization (dynamic analysis) in CT scanner | 0: absent 1: low (< 20UH) 2: > 20 UH without new blood vessels 3: > 20 UH and/or with new blood vessels | baseline | 
| Contrast enhancement curve (absent, slow or fast) in CT scanner |  | baseline | 
| Maximal intensity of enhancement peak in CT scanner |  | baseline | 
| Mean transit time of enhancement in CT scanner |  | baseline | 
| Gradient of contrast enhancement curve in CT scanner |  | baseline | 
| Contrast enhancement curve (absent, slow or fast) in MRI |  | baseline | 
| Maximal intensity of enhancement peak in MRI |  | baseline | 
| Mean transit time of enhancement in MRI |  | baseline | 
| Gradient of contrast enhancement curve in MRI |  | baseline | 
| Choline peak in magnetic resonance spectroscopy | Choline presence was defined as a clear metabolite peak at 3.2 ppm | baseline | 
| Apparent diffusion coefficient (ADC) in MR diffusion weighted imaging | ADC value in mm2/s | baseline | 
| Area under the perfusion curve in MRI |  | baseline | 
| Perfusion curve gradient in MRI |  | baseline | 
| Perfusion time-to-peak in MRI |  | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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MR imaging, Diffusion weighted imaging, MR proton spectroscopy, CT perfusion, Contrast enhanced ultrasound