What imaging studies are required?

Most patients with musculoskeletal tumors will undergo more than one kind of imaging study. The various imaging studies provide complementary information

Plain radiograph (X-Ray)

shows the overall appearance of bone tumors. Experienced Orthopedic Oncologists and Skeletal Radiologists can predict the diagnosis of a bone tumor with the plain radiograph since most tumors have a "typical" appearance on x-ray.

Computed tomography (CT)

is very useful because it reveals the fine details of bone lesions.

Magnetic Resonance Imaging (MRI)

reveals details of normal and abnormal soft tissues. It is also good at determining the extent of tumors in inside of bones.

Bone scan (Bone scintigraphy or Nuclear Medicine)

is a sensitive test of bone inflammation and can screen the entire skeleton at once. It is usually used to look for evidence of tumor spread to other bones. For the test, the patient is given an intravenous injection of a radiotracer compound. Then, at intervals following the injection, a special camera is used to record uptake of this radiotracer from the skeleton. Since bone inflammation can be due to fracture and infection as well as tumors, bone scan findings must often be confirmed with other tests or a biopsy.

Angiography

is an imaging study that shows only the arteries (and veins) in a part of the body. It is usually used in advance of surgery to reveal precise vascular anatomy. It is also very useful in determining the amount of tumor vascularity which usually corresponds to how quickly a tumor is growing.

PET scan (Positron Emission Tomography)

is analagous to a bone scan in that a radiotracer is injected and that entire body is imaged, however, the level of detail in the image is finer and PET scan is more sensitive for soft tissue lesions than bone scan.