Role of radiologic imaging in management planning of giant cell tumor of bone.

The radiologic studies of 24 patients with giant cell tumors were evaluated with respect to their ability to determine tumor extent and to influence management. Computed tomography (CT) was the most accurate method for detecting soft tissue tumor extension, and conventional tomography was the best technique for evaluating penetration of subarticular cortical bone. Detection of these findings led to performance of en bloc tumor resection rather than curettage and grafting in patients with lower extremity tumors. Arthrotomography was helpful in some instances in detecting cartilage and joint invasion by tumor, joint invasion being an indication for extra-articular rather than transarticular tumor resection. Scintigraphy was not as accurate as conventional tomography or CT in determining intraosseous tumor extent because of increased tracer uptake beyond the true tumor limits in several cases. Angiography has been largely replaced by CT in evaluating giant cell tumors.