Imaging of Soft-Tissue Musculoskeletal Masses: Fundamental Concepts (original) (raw)
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Imaging evaluation of musculoskeletal tumors
Cancer treatment and research, 2014
In this chapter, we review different imaging modalities, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine scintigraphy, and their application to musculoskeletal neoplasm. Advantages and limitations of each modality are reviewed, and suggestions for imaging approach are provided.
Mri Evaluation Of Musculoskeletal Tumours In Correlation With Conventional Radiography
Introduction: Since the beginning of the twentieth century, there has been enormous progress in the diagnosis and therapy of musculoskeletal tumors, leading to substantial improvements in overall prognosis and patient survival. This progress has resulted largely from the development of an integrated, multidisciplinary approach to musculoskeletal tumors and from advances in multiple medical specialities, perhaps most notably in the new medical imaging speciality, radiology. Materials and Methods: MR imaging was performed on a 1.5T MRI system. Patient's position was determined by the area of abnormality. Body or surface coils were used according to the site of involvement. The smallest local coil that adequately covers the anatomic area was used for imaging. The closest joint was included in the field of view in at least one plane to provide a landmark for surgical localisation. The region of abnormality was positioned as close to the centre of the coil as possible. Prior to imaging the region of interest, a large field of view localiser using an increased diameter surface coil or body coil was used to accurately determine the proximal and distal extension of a large lesion, wherever required. Slice thickness was 2mm. Results: The present study was carried out on 40 patients of musculoskeletal tumors suspected clinically and/or on plain radiography. All the cases in the study attended outpatient or were inpatients at ASRAMS. Patients were examined radiologically and findings were recorded as per proforma attached, in all cases. In all patients, plain radiographs were done first followed by MRI (T1W, T2W, STIR, sequences were used to obtain images in coronal, sagittal and axial planes).
The Role of Diffusion-Weighted MRI in the Characterization of Musculoskeletal Soft Tissue Tumors
The Egyptian Journal of Hospital Medicine, 2017
Background: magnetic resonance imaging (MRI) has an important role in characterization of soft tissue tumors, yet, it lacks specificity for differentiation between the benign and malignant lesions. Aim of the Work: this study aimed to evaluate the ability of DW MRI in detection and characterization of the musculoskeletal soft tissue tumors. Patients and methods: this prospective study included 30 patients (20 females and 10 males) referred to MRI unit Ain shams University Hospital for MRI evaluation of musculoskeletal soft tissue tumors. Results: from 30 cases, 12 cases were benign (40%), 18 cases malignant (60%). From 12 cases of the benign, 8 cases were ≤ 40 years and 4 cases were > 40. From 18 cases of the malignant, 7 cases were ≤ 40 and 11 cases > 40. Ranging of ADC value of benign tumors (1.72-2.58); mean ADC (2.21 10-3 mm 2 /sec). Ranging of ADC value of malignant tumors was 0.52-1.82. Mean ADC value was 0.90 10-3 mm 2 /sec. Cutoff ADC value ≤ 1.14 less than 1.14 was benign and more than 1.14 was malignant; sensitivity 94.4% and specificity 91.7%. Conclusion: DWI with ADC mapping and measurement of ADC value proved to be a valuable non-invasive tool in differentiating between benign and malignant musculoskeletal soft tissue tumors. Recommendations: a larger population for future studies is needed. Thus, histopathologic work up is required for reliable characterization of soft tissue tumors (4) .
Musculoskeletal tumors throughout history and beyond: clinical features, imaging, staging and biopsy
Journal of the Pakistan Medical Association, 2020
Background: Over the last century, there has been a remarkable development in the study of bone and soft tissue sarcomas. This is primarily due to the improved knowledge of the nature of these lesions and the improved imaging technology. In literature there are many protocols that are being used and all of them have reported various advantages and disadvantages of each technique used. However, there is no set guideline and whatever has been proposed has been developed on the basis of the experience of different centres and different surgeons. Objective: The current systematic review was planned to thoroughly evaluate the levels of evidence on which we base decisions for surgical management of lower extremity bone tumours. Methods: The review included descriptive studies published in the English language. Studies included case reports, case series and experiences of different P r o v i s i o n a l l y A c c e p t e d f o r P u b l i c a t i o n 2 centres for the surgical management of lower extremity bone tumours. Articles reporting all levels of evidence-Level I to V-were included. PubMed, ERIC, MEDLINE, EMBASE and Cochrane Reviews databases from 2002 to 2012 were searched. Results: Information was gathered and thoroughly studied from 63 articles. There were no Level I studies, 2(3.2%) Level II studies, 47(74.6%) Level III, and the remaining 14(22.2%) studies were Level IV and Level V. Conclusion: Sarcomas are rarely occurring neoplastic conditions which are present in all age groups but commonly affect young age population. Most are asymptomatic but can present with pain or pathological fracture. These lesions are commonly diagnosed with plain radiographs. CT scan and MRI may be used to delineate anatomy and to quantify the extent of soft tissue involvement. Various advantages and disadvantages associated with each aspect in the management of patients starting from the basic history-taking, physical examination, imaging, biopsy principles, peri-operative laboratory work-up and staging of the cancer were studied. Treatment ranges from conservative to enblock resection including extended curettage. Aggressive tumors should be closely followed up for recurrence and metastasis.
IOSR Journals , 2019
MRI is the most useful investigation following plain x-rays in the detection and further evaluation of both bone and soft tissue sarcomas. The multiplanar capability, combined with the excellent soft tissue contrast and anatomical detail, mean that even small soft tissue or bony lesions can be detected withaccuracy. The MRI appearance of some tissues is characteristic, so that the diagnosis may be apparent or the differential diagnoses narrowed following the MRI scan. Tissues that have a characteristic appearance on MRI include fat and hyaline cartilage. Some vascular lesions are also typical, such as arteriovenous malformations that exhibit flow voids due to rapid blood flow and venous malformations with bright slow flowing or stagnant blood. Other tissues may have an appearance that, while not diagnostic, may be suggestive of a few tissue types, for example fibrous tissue, haemorrhagic tissue orcalcification
Diagnosis and Planning in the Management of Musculoskeletal Tumors: Surgical Perspective
Seminars in Interventional Radiology, 2010
The evaluation of musculoskeletal tumors requires a close interaction between the orthopedic oncologist, radiologist, and the pathologist. Successful outcome can be achieved in a considerable number of patients by following the appropriate diagnostic strategies and staging studies. The aim of this article is to outline the presentation, imaging, and staging of the primary and metastatic bone and soft tissue tumors. Some of the image-guided interventions for these tumors are also presented.
Current utilities of imaging in grading musculoskeletal soft tissue sarcomas
European journal of radiology, 2016
The care of patients with musculoskeletal malignancies has increasingly become a multidisciplinary function. Radiologists play an important role in many areas of these patients' care including initial diagnosis, staging, in many cases guiding therapy, and monitoring treatment response. However, the gold standard for the final diagnosis of these diseases remains the histopathologic proof. Intense efforts have been made to develop non-invasive methods of determining the tumor grade, or a surrogate, in order to predict biologic behavior, aid early treatment decisions, and provide prognostic information. Multiple imaging modalities have been employed in this domain-including computed tomography (CT); anatomic magnetic resonance (MR) imaging techniques; functional MR imaging sequences such as dynamic contrast enhancement (DCE), diffusion weighted imaging (DWI), MR spectroscopy (MRS); and positron emission tomography (PET). This article reviews current available literature in this rea...
Journal of Ultrasonography
The aim of this article is to provide a short review of the literature concerning the basic principles, usefulness and limitations of ultrasound-guided biopsy of musculoskeletal soft tissue tumors, with particular focus on core needle biopsies. Musculoskeletal soft-tissue tumors represent a rare and complex group of heterogeneous lesions. Prompt diagnosis of these uncommon lesions can improve the outcome and increase the patient survival rate. A biopsy examination of soft-tissue tumors with imaging modalities is necessary in all cases of aggressive or undetermined lesions. Although fine needle aspiration can be helpful for the biopsy of certain tumor types, core needle biopsy is a standard procedure in most tertiary sarcoma centers. It has a high diagnostic accuracy, low complication rate and lower price in comparison to open biopsy, and can replace it in the majority of cases of soft-tissue tumor assessment. However, the examining physician has to be familiar with the technique, an...
Radiology, 1997
To assess the relative accuracies of computed tomography (CT) and magnetic resonance (MR) imaging in the local staging of primary malignant bone and soft-tissue tumors. At four institutions, 367 eligible patients (aged 6-89 years) with malignant bone or soft-tissue neoplasms in selected anatomic sites were enrolled. Patients underwent both CT and MR imaging within 4 weeks before surgery. In each patient, CT scans were interpreted independently by two radiologists and MR images by two other radiologists at the enrolling institution. The CT and MR images were then interpreted together by two of those radiologists and subsequently reread at the other institutions. Imaging and histopathologic findings were compared and were supplemented when needed with surgical findings. Receiver operating characteristic curve analysis and descriptive statistical analysis were performed. Cases were analyzable in 316 patients: 183 had primary bone tumors; 133 had primary soft-tissue tumors. There was no...