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Semin Musculoskelet Radiol 2017; 21(05): 630-647
DOI: 10.1055/s-0037-1606130
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

ESSR Consensus Document for Detection, Characterization, and Referral Pathway for Tumors and Tumorlike Lesions of Bone

Radhesh Lalam
1   Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
,
Johan L. Bloem
2   Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
,
Iris M. Noebauer-Huhmann
3   Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
,
Klaus Wörtler
4   Department of Radiology, Technical University of Munich, Munich, Germany
,
Alberto Tagliafico
5   University of Genova and AOU IRCCS San Martino IST, Genova, Italy
,
Filip Vanhoenacker
6   Department of Radiology, Universities of Antwerp and Ghent, General Hospital Sint-Maarten, Duffel-Mechelen, Duffel, Belgium
,
Violeta Vasilevska Nikodinovska
7   Department of Radiology, University Surgical Clinic “St. Naum Ohridski,” University “Ss. Cyril and Methodius,” Skopje, Macedonia
,
Hatice Tuba Sanal
8   Department of Radiology, Health Sciences University, Gulhane School of Medicine, Ankara, Turkey
,
Henk-Jan van der Woude
9   Department of Radiology, Amsterdam and Leiden University Medical Center, Onze Lieve Vrouwe Gasthuis, Leiden, The Netherlands
,
Olympia Papakonstantinou
10   2nd Department of Radiology, National University of Athens, “Attikon” Hospital, Athens, Greece
,
Gunnar Åström
11   Department of Surgical Sciences–Radiology, Uppsala University, Uppsala, Sweden
,
Mark Davies
12   Midlands Musculoskeletal Imaging, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
,
Amanda Isaac
13   Guy's and St. Thomas' Hospitals NHS Foundation Trust, Kings College, London, United Kingdom
,
Marc-André Weber
14   Institute of Diagnostic and Interventional Radiology, University Hospital Rostock, Rostock, Germany
› Author Affiliations
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Publication History

Publication Date:
12 October 2017 (online)

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Abstract

Benign bone tumors are rare but are more common than primary malignant bone tumors. The early accurate diagnosis and reliable differentiation of these rare benign tumors and tumor mimickers from the even rarer malignant tumors with subsequent appropriate treatment or watchful waiting is crucial for the clinical outcome. Bone tumors are often a source of diagnostic and therapeutic uncertainty. Thus this European Society of Musculoskeletal Radiology consensus document is intended to help radiologists in their decision making and support discussion among clinicians who deal with patients with suspected or proven bone tumors. Evaluating these tumors starts with a patient history and physical examination. Radiography is the principal imaging modality and often can reliably diagnose a benign bone tumor by providing information about localization, matrix, aggressiveness, size, and (potential) multiplicity. In a significant number of cases, additional imaging is not necessary. Potentially malignant entities recognized by radiography should be referred for magnetic resonance imaging, which also serves as a preoperative local staging modality, with specific technical requirements. Indeterminate tumors, or tumors in which therapy depends on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist regional sarcoma treatment center (RSTC), where a multidisciplinary tumor team, including a specialist pathologist, radiologist, and sarcoma surgeon, are involved. Additional staging modalities are entity specific and should be performed according to the recommendations of the RSTC.

Keywords

bone tumor - bone tumor mimickers - consensus statement - diagnostic algorithm - imaging methods - ESSR

Note

This article was approved by the ESSR MSK Tumor Subcommittee. It was submitted as a consensus article to the Seminars in Musculoskeletal Radiology.