What are the features of primary rib and sternebral tumors on CT?

VRU 2023 - 64(4): 605-614

Background: The page is an article from the journal Veterinary Radiology & Ultrasound, published in July 2023. It reports on a study of CT features of primary bone neoplasia of the thoracic wall in dogs.

Study: The study was a retrospective, multi-center, observational study that included 58 dogs with a diagnosis of primary thoracic wall bone neoplasia and thoracic CT study. The aim was to describe the CT features of different tumor types and test the hypothesis that CT features would differ among tumor types.

Methods: The CT images were randomized and blindly analyzed by a board-certified veterinary radiologist, who recorded several qualitative and quantitative features of the lesions. The tumor types were confirmed by cytology or histology. Statistical analysis was performed to compare the CT findings among the tumor types.

Results: The most common tumor type was osteosarcoma (OSA), followed by chondrosarcoma (CSA) and hemangiosarcoma (HSA). The majority of the tumors arose from the ribs, with only a few cases of sternal masses. The tumors showed severe invasiveness, mild/moderate contrast enhancement, and different grades of mineral attenuation. The presence of sternal lymphadenopathy was significantly more frequent in dogs with OSA and HSA compared to dogs with CSA. Dogs with HSA showed significantly lower mineral attenuation grades compared to dogs with OSA.

Limitations: The study had several limitations, such as the retrospective design, the non-standardized CT technique, the low number of cases, and the lack of data regarding treatment and survival times.

Conclusions: The study concluded that mesenchymal thoracic wall bone neoplasia appeared as large masses, invading the thoracic cavity in dogs. The presence of sternal lymphadenopathy and a low grade of mineral attenuation within the lesion could be useful CT features to distinguish thoracic wall CSA from other tumor types and HSA from OSA, respectively.

Examples of neoplasia arising from the sternum (A, B) and from the rib (C,D). A,B, Sagittal reconstruction of the thorax of a dog with sternal OSA (between arrowheads), bone window (A) and post-contrast soft tissue window (B) showing a large, heterogeneous mass, with mineralized and soft tissue components, occupying the cranial aspect of the thoracic cavity. C,D, Transverse plane in bone window (C) and post-contrast soft tissue window (D) of the cranial thorax of a dog with OSA of the second left rib (between arrowheads), characterized by mixed attenuation, with large mineralized portions, and invasion of the thoracic cavity. t = trachea. Helical modality, 120 kVp, 200 mAs, image matrix 512 × 512, 0.5 mm slice thickness.

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