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MRI in Neoplastic Bone Disease and Differential Considerations

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MRI of the Spine

Abstract

Differentiating benign and malignant lesions of the osseous spine on imaging can be a daunting task for even the most seasoned radiologist. In addition to recognizing specific magnetic resonance imaging (MRI) features of osseous spinal tumors, radiologists can narrow the differential diagnosis by factoring in patient demographics and tumor location along the longitudinal extent of the spine as well as within a vertebra. Furthermore, familiarity with the current World Health Organization’s tumor designations and the incidence of specific tumors based upon patient age is important for the interpreting radiologist. This chapter will cover unique and sometimes overlapping MRI features of a variety of benign (venous malformation, aneurysmal bone cyst, osteochondroma, osteoid osteoma, osteoblastoma, bone island) and malignant (metastases, myeloma, leukemia, chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma) osseous spinal tumors.

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References

  1. Hameed M, Wold LE. Hemangioma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 332.

    Google Scholar 

  2. Unni KK, Inwards CY. Benign vascular tumors. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 262–71.

    Google Scholar 

  3. Flemming DJ, Murphey MD, Carmichael BB, et al. Primary tumors of the spine. Semin Musculoskelet Radiol. 2000;4:299–320.

    Article  CAS  PubMed  Google Scholar 

  4. Alexander J, Meir A, Vrodos N, et al. Vertebral hemangioma: an important differential in the evaluation of locally aggressive spinal lesions. Spine. 2010;35:E917–20.

    Article  PubMed  Google Scholar 

  5. Rosenberg AE, Bridge JA. Lipoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 341.

    Google Scholar 

  6. Nielsen GP, Fletcher JA, Oliviera AM. Aneurysmal bone cyst. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 348–9.

    Google Scholar 

  7. Unni KK, Inwards CY. Conditions that commonly simulate primary neoplasms of bone. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 305–80.

    Google Scholar 

  8. Mankin HJ, Hornicek FJ, Ortiz-Cruz E, et al. Aneurysmal bone cyst: a review of 150 patients. J Clin Oncol. 2005;23(27):6756–62.

    Article  PubMed  Google Scholar 

  9. Athanasou NA, Bensai M, Forsyth R, et al. Giant cell tumour of bone. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 321.

    Google Scholar 

  10. Unni KK, Inwards CY. Giant cell tumor (osteoclastoma). In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 225–42.

    Google Scholar 

  11. Chakarun CJ, Forrester DM, Gottsegen CJ, et al. Giant cell tumor of bone: review, mimics, and new developments in treatment. Radiographics. 2013;33:197–211.

    Article  PubMed  Google Scholar 

  12. Raskin KA, Schwab JH, Mankin HJ, et al. Giant cell tumor of bone. J Am Acad Orthop Surg. 2013;21(2):118–26.

    Article  PubMed  Google Scholar 

  13. JVMG B, Heymann D, Wuyts W. Osteochondroma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 250–1.

    Google Scholar 

  14. Unni KK, Inwards CY. Osteochondroma (osteocartilaginous exostosis). In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 9–20.

    Google Scholar 

  15. Murphey MD, Choi JJ, Kransdorf MJ, et al. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 2000;20(5):1407–34.

    Article  CAS  PubMed  Google Scholar 

  16. Bernard SA, Murphey MD, Flemming DJ, et al. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255:857–65.

    Article  PubMed  Google Scholar 

  17. Pierz KA, Stieber JR, Kusumi K, et al. Hereditary multiple exostoses: one center’s experience and review of etiology. Clin Orthop Relat Res. 2002;401:49–59.

    Article  Google Scholar 

  18. Ruivo C, Hopper MA. Spinal chondrosarcoma arising from a solitary lumbar osteochondroma. JBR-BTR. 2014;97(1):21–4.

    CAS  PubMed  Google Scholar 

  19. Horvai A, Klein M. Osteoid osteoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 227–8.

    Google Scholar 

  20. Unni KK, Inwards CY. Osteoid osteoma. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 102–10.

    Google Scholar 

  21. deAndrea CE, Bridge JA, Schiller A. Osteoblastoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 279–80.

    Google Scholar 

  22. Unni KK, Inwards CY. Osteoblastoma (giant osteoid osteoma). In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 112–21.

    Google Scholar 

  23. Chai JW, Hong SH, Choi JY, et al. Radiologic diagnosis of osteoid osteoma: from simple to challenging findings. Radiographics. 2010;30:737–49.

    Article  PubMed  Google Scholar 

  24. Davies M, Cassar-Pullicino VN, McCall IW, et al. The diagnostic accuracy of MR imaging in osteoid osteoma. Skelet Radiol. 2002;31(10):559–69.

    Article  Google Scholar 

  25. Lucas DR, Unni KK, McLeod RA, et al. Osteoblastoma: clinicopathologic study of 306 cases. Hum Pathol. 1994;25:117–34.

    Article  CAS  PubMed  Google Scholar 

  26. Baumhoer D, Bras J. Osteoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 276.

    Google Scholar 

  27. Unni KK, Inwards CY. Conditions that commonly simulate primary neoplasms of bones. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 305–80.

    Google Scholar 

  28. Ihde LL, Forrester DM, Gottsegen CJ, et al. Sclerosing bone dysplasias: review and differentiation from other causes of osteosclerosis. Radiographics. 2011;31(7):1865–82.

    Article  PubMed  Google Scholar 

  29. Ulano A, Bredella MA, Burke P, et al. Distinguishing untreated osteoblastic metastases from enostoses using CT attenuation measurements. AJR Am J Roentgenol. 2016;207(2):362–8.

    Article  PubMed  Google Scholar 

  30. Unni KK, Inwards CY. Conditions that commonly simulate primary neoplasms of bones. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 305–80.

    Google Scholar 

  31. Kaloostian PE, Yurter A, Zadnik PL, et al. Current paradigms for metastatic spinal disease: an evidence-based review. Ann Surg Oncol. 2014;21(1):248–62.

    Article  CAS  PubMed  Google Scholar 

  32. Lorsbach R, Kluin PM. Plasma cell myeloma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 312–4.

    Google Scholar 

  33. Unni KK, Inwards CY. Myeloma. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 191–200.

    Google Scholar 

  34. Lorsbach R, Kluin PM. Solitary plasmacytoma of bone. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 315.

    Google Scholar 

  35. Dimopoulos MA, Hillengass J, Usmani S, et al. Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement. J Clin Oncol. 2015;33(6):657–64.

    Article  PubMed  Google Scholar 

  36. Ferraro R, Agarwal A, Martin-Macintosh EL, et al. MR imaging and PET/CT in diagnosis and management of multiple myeloma. Radiographics. 2015;35:438–54.

    Article  PubMed  Google Scholar 

  37. Mulligan ME, Badros AZ. PET/CT and MR imaging in myeloma. Skelet Radiol. 2007;36:5–16.

    Article  Google Scholar 

  38. Hanrahan CJ, Cr C, Crim JR. Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET/CT. Radiographics. 2010;30(1):127–42.

    Article  PubMed  Google Scholar 

  39. Brunning RD, Matutes E, Harris NL, et al. Acute myeloid leukemia. In: Jaffe ES, et al., editors. Pathology and genetics: tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2001. p. 77–80.

    Google Scholar 

  40. Unni KK, Inwards CY. Malignant lymphoma of bone. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 201–10.

    Google Scholar 

  41. Flanagan AM, Yamaguchi T. Chordoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 328–9.

    Google Scholar 

  42. Unni KK, Inwards CY. Chordoma. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 248–60.

    Google Scholar 

  43. Sciubba DM, Chi JH, Rhines LD, et al. Chordoma of the spinal column. Neurosurg Clin N Am. 2008;19(1):5–15.

    Article  PubMed  Google Scholar 

  44. Hogendoorn PCW, Bovee JVMG, Nielsen GP. Chondrosarcoma (grades I-III), including primary and secondary variants and periosteal chondrosarcoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 264–8.

    Google Scholar 

  45. Unni KK, Inwards CY. Chondrosarcoma (primary, secondary, dedifferentiated, and clear cell). In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 60–91.

    Google Scholar 

  46. Giuffrida AY, Burgueno J, Gutierrez JC, et al. Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am. 2009;91(5):1063–72.

    Article  PubMed  Google Scholar 

  47. McLoughlin GS, Sciubba DM, Wolinsky JP. Chondroma/chondrosarcoma of the spine. Neurosurg Clin N Am. 2008;19(1):57–63.

    Article  PubMed  Google Scholar 

  48. Murphey MD, Walker EA, Wilson AJ, et al. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics. 2003;23:1245–78.

    Article  PubMed  Google Scholar 

  49. deAlava E, Lesnick SL, Sorensen PH. Ewing sarcoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 306–9.

    Google Scholar 

  50. Unni KK, Inwards CY. Ewing tumor. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 211–24.

    Google Scholar 

  51. Balamuth NJ, Womer RB. Ewing's sarcoma. Lancet Oncol. 2010;11(2):184–92.

    Article  CAS  PubMed  Google Scholar 

  52. Murphey MD, Senchak LT, Mambalam PK, et al. From the radiologic pathology archives: Ewing sarcoma family of tumors: radiologic-pathologic correlation. Radiographics. 2013;33:803–31.

    Article  PubMed  Google Scholar 

  53. Rosenberg AE, Cleton-Jansen AM, de Pinieux G, et al. Conventional osteosarcoma. In: Fletcher DM, et al., editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 282–8.

    Google Scholar 

  54. Unni KK, Inwards CY. Conditions that commonly simulate primary neoplasms of bones. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott; 2010. p. 122–54.

    Google Scholar 

  55. Ropper AE, Cahill KS, Hanna JW, et al. Primary vertebral tumors: a review of epidemiologic, histological and imaging findings, Part II: Locally aggressive and malignant tumors. Neurosurgery. 2012;70:211–9.

    Article  PubMed  Google Scholar 

  56. Orguc S, Arkun R. Primary tumors of the spine. Semin Musculoskelet Radiol. 2014;18:280–99.

    Article  PubMed  Google Scholar 

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Correspondence to John V. Dennison .

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Dennison, J.V. et al. (2020). MRI in Neoplastic Bone Disease and Differential Considerations. In: Morrison, W., Carrino, J., Flanders, A. (eds) MRI of the Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-43627-8_8

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  • DOI: https://doi.org/10.1007/978-3-030-43627-8_8

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