Figure 1
From: Radiological and pathological characteristics of giant cell tumor of bone treated with denosumab
Pre-treatment radiological analyses of the left knee of the patient. Plain radiographs show a soap-bubbly osteolytic lesion with thinned cortical bone in the epiphysis of the proximal tibia (A, B) and small osteolytic lesions with a nonsclerotic margin in the metaphysis of the distal femur (arrow). MRI shows a proximal tibial tumor displaying iso-intensity to the surrounding muscle on T1-weighted imaging (coronal view) (C), heterogeneous high intensity on T2-weighted fat-suppression imaging (axial view) (D), and diffuse enhancement on gadolinium-enhanced T1-weighted fat-suppression imaging (coronal view) (E). Enhancement of surrounding soft tissue which indicates an occult pathological fracture is also observed. Sagittal MRI of the distal tibia shows small lesions (arrows) displaying nearly the same patterns as the tibial tumor; iso-intensity to the surrounding muscle on T1-weighted imaging (F), high intensity on T2-weighted imaging (G), and diffuse enhancement on gadolinium-enhanced T1-weighted fat-suppression imaging (H). 18F-FDG PET/CT revealed the proximal tibial tumor showing marked bone destruction (I) with increased SUV uptake (SUVmax: 9.6) (J) and the distal femoral lesions with slightly increased SUV uptake (SUVmax: 0.7) (arrow) (K).