الفهرس 
Review of types and classification of bone tumorsOnly 14 pages are availabe for public view
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Abstract
Proper selection of the appropriate imaging techniques for the evaluation of a patient with a suspected bone tumor is crucial for successful diagnosis and management.
There are four techniques used in bone tumor imaging:
conventional radiography, CT, MRI and isotope bone scan. Angiography is rarely used.
Conventional radiography is sufficient in several benign lesions not requiring treatment.
Complete imaging work-up is indicated in the tumors requiring surgical treatment.
Adequate MR studies require professional skills and the knowledge of bone disorders.
Imaging should demonstrate all the extensions of the tumor, some of which may be difficult to detect or remain occult.
Treatment failure often depends on incomplete, inadequate or misinterpreted imaging findings.
Radiography remains by far the most effective single tool for the differential diagnosis of bone tumor and tumor-like lesions. Furthermore, thanks to its high specificity in detecting lesion features, radiography integrated with clinical findings may allow the differential diagnosis between neoplastic and non-neoplastic lesions.
The role of computed tomography (CT) can be divided into two components: firstly, detailed evaluation of local disease; and secondly, optimal assessment of pulmonary metastases. CT
is the superior method for demonstrating the type of cortical destruction and the presence of matrix mineralization. CT should therefore be used as a problem-solving tool in complementing radiography in suboptimal situations.
MRI plays a major role in the evaluation and treatment planning of bone tumors. It should be used following plain films and before biopsy. The MR appearance of most tumors is nonspecific; however, the entire extent of the tumor and its relationship to adjacent structures can be determined at MRI providing a road map for the surgeon. The role of dynamic enhancement is evolving and has not yet been determined.
Recent advances in MR imaging, particularly the development of fast imaging techniques, have markedly reduced imaging time without compromising image quality. This has made feasible the clinical introduction of whole body MRI as a practical diagnostic tool. Whole body MRI is a valid, non-ionising and sensitive clinical tool. The technique will likely have its greatest impact in the evaluation of patients with suspected bone marrow or skeletal involvement by either metastases or myeloma, and in the search for a primary tumor in children and pregnant patients.
The integration between dynamic nuclear medicine and the anatomical detailing provided by conventional radiology is necessary to increase imaging sensitivity and specificity for best patient management. Radiologists, oncologists, surgeons, pathologists and nuclear medicine specialists should cooperate to customize the diagnostic work-up to individual needs, to avoid useless examinations and finally to reduce the cost of patient management.
Angiography is helpful in selected cases, such as performing selective arterial imbolization, in complex vertebral surgery or when there is vascular damage or vascular complication due to the tumor or consequence of the treatment.