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Semin Musculoskelet Radiol 2015; 19(05): 463-474
DOI: 10.1055/s-0035-1569250
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Advanced Techniques in Musculoskeletal Oncology: Perfusion, Diffusion, and Spectroscopy

Pedro A. Gondim Teixeira
1   Service D'imagerie Guilloz, Hôpital Central, CHU Nancy, France
2   Université de Lorraine, Nancy, France
5   Centre Chirurgical Emile Gallé, Nancy, France
,
Marine Beaumont
2   Université de Lorraine, Nancy, France
,
Hossu Gabriela
2   Université de Lorraine, Nancy, France
,
Chen Bailiang
2   Université de Lorraine, Nancy, France
,
Jean-luc Verhaeghe
3   Service de Chirurgie Institut de Cancerologie de Lorraine, Vandoeuvre-les-Nancy, France
,
François Sirveaux
4   Service de Chirurgie Traumatologique et Orthopédique, France
,
Alain Blum
1   Service D'imagerie Guilloz, Hôpital Central, CHU Nancy, France
› Author Affiliations
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Publication History

Publication Date:
22 December 2015 (online)

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Abstract

The imaging characterization of musculoskeletal tumors can be challenging, and a significant number of lesions remain indeterminate when conventional imaging protocols are used. In recent years, clinical availability of functional imaging methods has increased. Functional imaging has the potential to improve tumor detection, characterization, and follow-up. The most frequently used functional methods are perfusion imaging, diffusion-weighted imaging (DWI), and MR proton spectroscopy (MRS). Each of these techniques has specific protocol requirements and diagnostic pitfalls that need to be acknowledged to avoid misdiagnoses. Additionally, the application of functional methods in the MSK system has various technical issues that need to be addressed to ensure data quality and comparability. In this article, the application of contrast-enhanced perfusion imaging, DWI, and MRS for the evaluation of bone and soft tissue tumors is discussed, with emphasis on acquisition protocols, technical difficulties, and current clinical indications.

Keywords

musculoskeletal oncology - MRI - diffusion-weighted imaging - perfusion - proton spectroscopy
 

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