Indications for epiphyseal preservation in metaphyseal malignant bone tumors of children: Relationship between image methods and histological findings

We compared several image methods in the evaluation of the possible physeal effect in 47 osteosarcomas and 18 Ewing's sarcomas in children. The minima l follow-up was 3 years (range, 3-17). In the histological study, the physi s was affected in 53% of the cases. We correlated the histological findings and the findings from the different image methods. There were more false-p ositive than false-negative results, and in the computed tomography and mag netic resonance imaging (MRI) studies, there were no false negatives. The a ccuracy of MRI (predictive positive value plus predictive negative value) w as the best (90.3%), and it is the technique that we prefer. According to t hese findings, we can safely preserve the epiphysis in cases of metaphyseal tumors showing no contact between the tumor and the growth plate in the MR I images. If the tumor shows contact with part of the physis, it is also po ssible to preserve the epiphysis.