Musculoskeletal Tumor Update

I had the honor of coordinating the Scientific Focus Session for the last annual meeting of the Society of Skeletal Radiology (SSR), and chose Musculoskeletal Tumor Update as the topic for presentation and subsequent discussion among its members and attendees. This session was well received and the editors of Seminars in Musculoskeletal Radiology asked if we could make this information available to a larger audience. Due to prior commitments of some of the speakers, not all of the SSR lecture material is included in this issue of Seminars.

Mark D. Murphey, M.D., from the Armed Forces Institute of Pathology, has generated a document highlighting the 2002 World Health Organization's nomenclature modifications for soft tissue neoplasm classification. The most significant changes in nomenclature involve the group of fibrous and lipomatous malignancies.

Jerzy Lasota, M.D. and Julie C. Fanburg-Smith, M.D. are pathologists from the Armed Forces Institute of Pathology. Their article on mesenchymal tumor genetics provides insight into the emerging world of musculoskeletal tumor diagnosis beyond imaging.

Michael E. Mulligan, M.D., from the University of Maryland, nicely outlines the imaging techniques for diagnosis, staging, and follow-up of multiple myeloma, which is the most common primary bone malignancy and one of the most common hematologic malignancies.

Laura M. Fayad, M.D., Peter B. Barker, Ph.D., and David A. Bluemke, M.D., Ph.D., from John Hopkins Medical Institute, discuss the technical aspects of performing proton MR spectroscopy. They delineate the differences between single voxel and multivoxel technique, as well as the advantages and limitations, and potential utility of MR spectroscopy in the evaluation of musculoskeletal lesions.

Jeffrey J. Peterson, M.D., from Mayo Clinic Jacksonville, has compiled information regarding the use of FDG-PET for musculoskeletal tumor evaluation. He summarizes the benefits of FDG-PET in the detection of osseous metastases, as well as the staging, restaging, and monitoring of treatment response of patients with musculoskeletal tumors.

Kenneth A. Buckwalter, M.D., from Indiana University, provides means to optimize CT and MRI examinations in postoperative patients. His article outlines specific ways to improve image quality, depending on the hardware alloy, the geometry of the hardware, and the location of the hardware relative to the region of interest.

Finally, Mary I. O'Connor, M.D., from Mayo Clinic Jacksonville, gives an oncologic orthopedist's perspective on the specific imaging information that the radiologist can provide, to help determine the appropriate surgical treatment for patients with musculoskeletal tumors.