They cautioned that osteoid osteoma may be difficult to identify on MRI and the imaging features may be easily misinterpreted. In a study including 19 patients with histologically proven osteoid osteoma who underwent CT and MRI before excision of the lesion, Assoun et al [15] found that MRI was better than CT in showing intramedullary and soft-tissue changes in all cases. However, the authors cautioned that such findings on MRI may produce a misleading aggressive appearance. Liu et al [18] performed a retrospective study including 11 patients with pathologically proven osteoid osteomas who underwent nonenhanced MRI, dynamic gadolinium-enhanced MRI, and CT. They showed that compared with CT, dynamic gadolinium-enhanced MRI demonstrated the osteoid osteoma equally well in 8 of 11 patients and with better conspicuity in 3 of 11 patients, although this difference was not statistically significant (P = . 69). Furthermore, the dynamic gadolinium-enhanced MRIs demonstrated the osteoid osteomas significantly better than the nonenhanced T1-weighted (P < . 001) and T2-weighted (P < . 001) MRIs. In the majority of cases, peak enhancement of the osteoid osteoma occurred in the Primary Bone Tumors arterial phase with early partial washout. However, MRI without IV contrast or MRI without and with IV contrast may be useful in some cases to identify alternative diagnoses such as osteomyelitis. Bone Scan Whole Body Bone scan is sensitive for the detection of osteoid osteoma but lacks specificity [19]. Bone Scan Whole Body with SPECT or SPECT/CT Area of Interest Bone scan is sensitive for the detection of osteoid osteoma but lacks specificity. Single-photon emission computed tomography (SPECT) or SPECT/CT may help improve specificity [19]. US Area of Interest US is not routinely used in the evaluation of suspected osteoid osteoma. There is no relevant literature regarding the use of US in the evaluation of suspected osteoid osteoma. Variant 5: Suspect primary bone tumor. Lesion on radiographs.
Primary Bone Tumors. They cautioned that osteoid osteoma may be difficult to identify on MRI and the imaging features may be easily misinterpreted. In a study including 19 patients with histologically proven osteoid osteoma who underwent CT and MRI before excision of the lesion, Assoun et al [15] found that MRI was better than CT in showing intramedullary and soft-tissue changes in all cases. However, the authors cautioned that such findings on MRI may produce a misleading aggressive appearance. Liu et al [18] performed a retrospective study including 11 patients with pathologically proven osteoid osteomas who underwent nonenhanced MRI, dynamic gadolinium-enhanced MRI, and CT. They showed that compared with CT, dynamic gadolinium-enhanced MRI demonstrated the osteoid osteoma equally well in 8 of 11 patients and with better conspicuity in 3 of 11 patients, although this difference was not statistically significant (P = . 69). Furthermore, the dynamic gadolinium-enhanced MRIs demonstrated the osteoid osteomas significantly better than the nonenhanced T1-weighted (P < . 001) and T2-weighted (P < . 001) MRIs. In the majority of cases, peak enhancement of the osteoid osteoma occurred in the Primary Bone Tumors arterial phase with early partial washout. However, MRI without IV contrast or MRI without and with IV contrast may be useful in some cases to identify alternative diagnoses such as osteomyelitis. Bone Scan Whole Body Bone scan is sensitive for the detection of osteoid osteoma but lacks specificity [19]. Bone Scan Whole Body with SPECT or SPECT/CT Area of Interest Bone scan is sensitive for the detection of osteoid osteoma but lacks specificity. Single-photon emission computed tomography (SPECT) or SPECT/CT may help improve specificity [19]. US Area of Interest US is not routinely used in the evaluation of suspected osteoid osteoma. There is no relevant literature regarding the use of US in the evaluation of suspected osteoid osteoma. Variant 5: Suspect primary bone tumor. Lesion on radiographs.