Conventional Modalities and Novel, Emerging Imaging Techniques for Musculoskeletal Tumors.

BACKGROUND Imaging of musculoskeletal tumors requires a multimodality approach and includes radiography, computed tomography (CT), and magnetic resonance imaging (MRI). METHODS Topics related to primary bone and soft-tissue tumors are reviewed. The fundamental imaging principles are discussed as well as the applications of emerging imaging modalities. RESULTS MRI is the preferred technique for the evaluation of musculoskeletal tumors, whereas other imaging modalities play a complementary role. Radiography is indicated as the first-line imaging modality in bone and soft-tissue tumors, whereas CT is the preferred modality for evaluating cortical osseous lesions or calcifications and in patients with contraindications to MRI. Positron emission tomography (PET)/CT and PET/MRI are helpful in identifying the glucose metabolism of the lesion. Ultrasonography is the most useful for biopsy guidance and can aid in differentiating cystic from solid masses and identifying vascularity. Novel modalities, such as diffusion-weighted imaging, spectroscopy, and habitat imaging, show promise in increasing diagnostic accuracy and affecting treatment strategies. CONCLUSIONS Conventional modalities and emerging, novel imaging techniques can provide noninvasive methods to diagnose and evaluate musculoskeletal tumors.