Bone Tumours - Level of Agreement Between Radiographic and Histological Diagnosis of Bone Tumours at Kenyatta National Hospital and PCEA Kikuyu Hospital

Abstract

Study Background: Bone tumours have a relatively low incidence but carry a disproportionately high mortality globally. Most benign lesions and malignant ones affect those in the second and third decades of life, the most productive age-groups in the population. The similar presenting symptoms and coextensive anatomic patterns pose a diagnostic challenge. The problem is worse in many developing countries where laboratory and imaging facilities are few and costly to most patients. It therefore calls for a higher clinical acumen in reaching a diagnosis especially in resource-strained setting where access to diagnostic equipment is limited to inform early treatment. Radiographs are readily available, affordable and provide a wealth of valuable information. Combining clinical information with X-ray features of bone lesions helps in reaching a diagnosis or possible differential that can be confirmed by histology, the gold standard. Published local data comparing diagnoses made based on radiographic features of bone tumours and their histology is finite. This study seeks to find out the level of accuracy of radiographical diagnoses compared to histological diagnoses among patients with bone tumours who present at the Kenyatta National Hospital (KNH) and PCEA Kikuyu hospitals. Study Objective: To determine the percent agreement between radiological and histological diagnoses among patients with bone tumours at KNH and PCEA Kikuyu hospitals. Study Site(s): KNH and PCEA Kikuyu hospitals. Study Design: This is both a prospective and retrospective descriptive study. Participants and Methods: All patients attending at KNH and PCEA Kikuyu hospitals over a period of 12 months: October 2021 to September 2022 presumed to have a bone tumour on plain radiography and additionally had histological diagnosis were recruited in the study. Data was retrieved from patient medical records in the respective hospitals. The details included patient demographics, presenting symptoms and their duration, tumour location in bone, plain radiography features of bone xi tumours, initial radiological diagnosis based on radiographs as well as the final histological diagnosis. Data management: The data collected using patient data sheets was analysed using the Statistical Package of Social Sciences (SPSS) version 26. Patient demographics, symptoms and tumour location was analysed descriptively and presented in graphical and tabular form. Percentage agreement between radiological and histological diagnoses as well as sensitivity and specificity of roentgenography in diagnosis of bone tumours was determined. Utility of the study: The study findings may be projected to a national level to identify the pertinent areas needed to improve care to patients with bone cancer through; 1. Inform on creation of tailored bone tumour diagnostic protocols. 2. Form a nucleus for generation of further research studies