Musculoskeletal Tumor Imaging: Focus on Emerging Techniques
Blake C.JonesMD, Laura M.FayadMD
Magnetic resonance imaging (MRI) is a central imaging modality for the evaluation of musculoskeletal bone and soft-tissue tumors. Conventional imaging with T1-weighted (T1W), T2-weighted (T2W), and static intravenous contrast-enhanced imaging retains the utility it has enjoyed since the early use of MRI.1-3 Over the years, many additional techniques have been developed that go beyond standard anatomical sequences and examine the functional and metabolic properties of tissue.4 Although many of these techniques have become standard in the routine evaluation of other organ systems, such as the brain, the musculoskeletal imaging community in general has lagged in adopting these advanced techniques. This likely relates to a number of factors, including the need to image a variety of tissue types, a heterogeneous spectrum of tumor pathology, body parts ranging from digits to large structures such as the pelvis, and moving structures that present additional challenges, such as the chest wall. These challenges necessitate optimizing MRI protocols for numerous different situations.
In this article, we will discuss advances in MRI techniques for imaging musculoskeletal tumors, with a particular focus on emerging noncontrast techniques. We will discuss the considerations required for specific tumors and patient populations and showcase the utility of various sequences in the assessment of musculoskeletal tumors.