Preoperative Radiological Parameters May Predict Recurrence in Giant Cell Tumor of Bone

Background Giant cell tumor of bone (GCTB) is a benign but locally aggressive bone neoplasm with a high risk of local recurrence. Identifying reliable radiological predictors of recurrence can improve surgical planning and patient outcomes. Methods In this retrospective study, 27 patients with histopathologically confirmed GCTB who underwent intralesional curettage, thermal cauterization, and PMMA were evaluated. Preoperative imaging parameters, including tumor volume, tumor-to-bone ratio, cortical thickness, subchondral distance, and MRI features such as paintbrush border and peritumoral edema, were analyzed for their association with recurrence, MSTS scores, and complications. Results The local recurrence rate was 11.1%. Paintbrush border appearance and increased tumor volume were significantly associated with recurrence (p = 0.01 and p = 0.009, respectively). Tumor volume showed a negative correlation with both pre- and postoperative MSTS scores. Thinner cortex in tumor-affected areas correlated with lower MSTS scores and higher soft tissue involvement. Tumor-to-bone ratio on AP radiographs also correlated significantly with recurrence, while subchondral distance did not. Conclusion Preoperative radiological findings such as tumor volume, cortical destruction, and paintbrush border may predict recurrence and functional outcomes in GCTB. Incorporating these parameters into treatment planning may reduce recurrence and improve functional recovery.