Bone Tumors and Tumor-Like Lesions

  • Mark J. Kransdorf
  • Mark D. Murphey


The imaging evaluation of musculoskeletal tumors has undergone dramatic evolution with the advent of computer-assisted imaging, specifically, computed tomography (CT) and magnetic resonance imaging (MRI). Despite these sophisticated imaging modalities, the objectives of initial radiologic evaluation remain unchanged: detecting the suspected lesion, establishing a diagnosis, or, when a definitive diagnosis is not possible, formulating an appropriate differential diagnosis, and determining the radiologic staging of the lesion [1]. A detailed discussion of all bone tumors is well beyond the scope of this review; instead, we highlight the initial evaluation and staging of primary osseous neoplasms.


Bone Tumor Giant Cell Tumor Ewing Sarcoma Periosteal Reaction Gadopentetate Dimeglumine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Hudson TM (1987) Radiologic-pathologie correlation of musculoskeletal lesions. Williams & Wilkins, Baltimore, pp 1–9Google Scholar
  2. 2.
    Madewell JE, Ragsdale BD, Sweet DE (1981) Analysis of solitary bone lesions. Part I. Internal margins. Radiol Clin North Am 19:715–748PubMedGoogle Scholar
  3. 3.
    Moser RP, Madewell JE (1987) An approach to primary bone tumors. Radiol Clin North Am 25:1049–1093PubMedGoogle Scholar
  4. 4.
    Ragsdale BD, Madewell JE, Sweet DE (1981) Analysis of solitary bone lesions. Part II. Periosteal reactions. Radiol Clin North Am 19:749–783PubMedGoogle Scholar
  5. 5.
    Sweet DE, Madewell JE, Ragsdale BD (1981) Analysis of solitary bone lesions. Part III. Matrix patterns. Radiol Clin North Am 19:785–814PubMedGoogle Scholar
  6. 6.
    Tehranzadeh J, Mnaymneh W, Ghavam C, Morillo G, Murphy BJ (1989) Comparison of CT and MR imaging in musculoskeletal neoplasms. J Comput Assist Tomogr 13:466–472CrossRefPubMedGoogle Scholar
  7. 7.
    Pettersson H, Gillespy T 3rd, Hamlin DJ et al (1987) Primary musculoskeletal tumors: examination with MR imaging compared with conventional modalities. Radiology 164:237–241PubMedGoogle Scholar
  8. 8.
    Panicek DM, Gatsonis C, Rosenthal DI et al (1997) CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: report of the Radiology Diagnostic Oncology Group. Radiology 202:237–246PubMedGoogle Scholar
  9. 9.
    Aisen AM, Martel W, Braunstein EM et al (1986) MRI and CT evaluation of primary bone and soft-tissue tumors. AJR Am J Roentgenol 146:749–756PubMedGoogle Scholar
  10. 10.
    Hudson TM, Hamlin DJ, Enneking WF, Pettersson H (1985) Magnetic resonance imaging of bone and soft tissue tumors: early experience in 31 patients compared with computed tomography. Skeletal Radiol 13:134–146CrossRefPubMedGoogle Scholar
  11. 11.
    Lang P, Johnston JO, Arenal-Romero F (1988) Advances in MR imaging of pediatric musculoskeletal neoplasms. Magn Reson Imaging Clin N Am 6:579–604Google Scholar
  12. 12.
    Zimmer WD, Berquist TH, McLeod RA et al (1985) Bone tumors: magnetic resonance imaging versus computed tomography. Radiology 155:709–718PubMedGoogle Scholar
  13. 13.
    Vanel D, Verstraete KL, Shapeero LG (1997) Primary tumors of the musculoskeletal system. Radiol Clin North Am 35:213–237PubMedGoogle Scholar
  14. 14.
    Sundaram M, McLeod RA (1990) MR imaging of tumor and tumorlike lesions of bone and soft tissue. AJR Am J Roentgenol 155:817–824PubMedGoogle Scholar
  15. 15.
    Schima W, Amann G, Stiglbauer R et al (1994) Preoperative staging of osteosarcoma: efficacy of MR imaging in detecting joint involvement. AJR Am J Roentgenol 163:1171–1175PubMedGoogle Scholar
  16. 16.
    Rubin DA, Kneeland JB (1994) MR imaging of the musculoskeletal system: technical considerations for enhancing image quality and diagnostic yield. AJR Am J Roentgenol 163:1155–1163PubMedGoogle Scholar
  17. 17.
    Mirowitz SA (1993) Fast scanning and fat-suppression MR imaging of musculoskeletal disorders. AJR Am J Roentgenol 161:1147–1157PubMedGoogle Scholar
  18. 18.
    Dwyer AJ, Frank JA, Sank VJ et al (1988) Short T1 inversion-recovery pulse sequence: analysis and initial experience in cancer imaging. Radiology 168:827–836PubMedGoogle Scholar
  19. 19.
    Shuman WP, Baron RL, Peters MJ, Tazioli PK (1989) Comparison of STIR and spin echo MR imaging at 1.5T in 90 lesions of the chest, liver and pelvis. AJR Am J Roentgenol 152:853–859PubMedGoogle Scholar
  20. 20.
    Cohen MD, Weetman RM, Provisor AJ et al (1986) Efficacy of magnetic resonance imaging in 139 children with tumors. Arch Surg 121:522–529PubMedGoogle Scholar
  21. 21.
    Sundaram M, McLeod RA (1988) Computed tomography or magnetic resonance for evaluation of solitary tumor and tumor-like lesions of bone. Skeletal Radiol 17:393–401CrossRefPubMedGoogle Scholar
  22. 22.
    Bloem JL, Taminiau AHM, Eulderink F et al (1988) Radiologic staging of primary bone sarcoma: MR imaging, scintigraphy, angiography, and CT correlated with pathologic examination. Radiology 169:805–810PubMedGoogle Scholar
  23. 23.
    Seeger LL, Widoff BE, Bassett LW et al (1991) Preoperative evaluation of osteosarcoma: value of gadopentetate dimeglumine-enhanced MR imaging. AJR Am J Roentgenol 157:347–351PubMedGoogle Scholar
  24. 24.
    Benedikt RA, Jelinek JS, Kransdorf MJ et al (1994) MR imaging of soft-tissue masses: role of gadopentetate dimeglumine. J Magn Reson Imaging 4:485–490CrossRefPubMedGoogle Scholar
  25. 25.
    Jordan RM, Mintz RD (1995) Fatal reaction to gadopentetate dimeglumine. AJR Am J Roentgenol. 164:743–744PubMedGoogle Scholar
  26. 26.
    Tardy B, Guy C, Barral G et al (1992) Anaphylactic shock induced by intravenous gadopentetate dimeglumine. Lancet 339:494CrossRefPubMedGoogle Scholar
  27. 27.
    Shellock FG, Hahn HP, Mink JH et al (1993) Adverse reaction to intravenous gadoteridol. Radiology 189:151–152PubMedGoogle Scholar
  28. 28.
    Fletcher BD, Hanna SL, Fairclough DL et al (1992) Pediatric musculoskeletal tumors: use of dynamic, contrast-enhanced MR imaging to monitor response to chemotherapy. Radiology 184:243–248PubMedGoogle Scholar
  29. 29.
    Shapeero LG, Henry-Amar M, Vanel D (1992) Response of osteosarcoma and Ewing sarcoma to preoperative chemotherapy: assessment with dynamic and static MR imaging and skeletal scintigraphy. Invest Radiol 27:989–991CrossRefPubMedGoogle Scholar
  30. 30.
    Shapeero LG, Vanel D (2000) Imaging evaluation of the response of high-grade osteosarcoma and Ewing sarcoma to chemotherapy with emphasis on dynamic contrast-enhanced magnetic resonance imaging. Semin Musculoskelet Radiol 4:137–146CrossRefPubMedGoogle Scholar
  31. 31.
    Nomikos GC, Murphey MD, Kransdorf MJ et al (2002) Primary bone tumors of the lower extremities. Radiol Clin N Amer 40:971–990CrossRefPubMedGoogle Scholar
  32. 32.
    Swan JS, Grist TM, Sproat IA et al (1995) Musculoskeletal neoplasms: preoperative evaluation with MR angiography. Radiology 194:519–524PubMedGoogle Scholar
  33. 33.
    Ekelund L, Herrlin K, Rydholm A (1982) Comparison of computed tomography and angiography in the evaluation of soft tissue tumors of the extremities. Acta Radiol Diagn 23:15–28Google Scholar
  34. 34.
    Abdel-Dayem HM (1997) The role of nuclear medicine in primary bone and soft tissue tumors. Semin Nucl Med 27:355–363CrossRefPubMedGoogle Scholar
  35. 35.
    Murphey MD, Flemming DJ, Boyea SR et al (1998) Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. Radiographics 18:1213–1237PubMedGoogle Scholar
  36. 36.
    Schulte M, Brecht-Krauss D, Werner M et al (1999) Evaluation of neoadjuvant therapy response of osteogenic sarcoma using FDG PET. J Nucl Med 40:1637–1643PubMedGoogle Scholar
  37. 37.
    Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop 153:106–120PubMedGoogle Scholar
  38. 38.
    American Joint Committee on Cancer (2002) American Joint Committee on Cancer (AJCC) Staging Manual, 6th edn. www. cancerstaging.netGoogle Scholar
  39. 39.
    Unni KK (1996) Dahlin’ s bone tumors. General Aspects and data on 11,087 cases, 5th edn. Lippincott-Raven, PhiladelphiaGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Mark J. Kransdorf
    • 1
    • 2
  • Mark D. Murphey
    • 2
    • 3
  1. 1.Department of RadiologyMayo ClinicJacksonvilleUSA
  2. 2.Department of Radiologic Pathology, Armed Forces Institute of PathologyWalter Reed Army Medical CenterWashington, DCUSA
  3. 3.Department of Radiology and Nuclear MedicineUniformed Services University of the Heath SciencesBethesdaUSA

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