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
