Although FDG- PET/CT can detect metabolically active tumors, there is no relevant literature regarding the use of FDG-PET/CT in patients with positive localized or regional symptoms and negative radiographs or findings that do not explain symptoms. Bone Scan Whole Body Despite its historical utility in detecting radiographically occult bone abnormalities, studies that are more recent have shown that MRI is superior in this role. A retrospective analysis comparing the sensitivity of MRI and scintigraphy in the detection of malignant bone tumors in 106 patients showed that MRI revealed a focal abnormality compatible with tumor that was occult on scintigraphy in 28% of cases [12]. Although not typically the next imaging study, bone scan remains a viable imaging option in select cases in which MRI is not clinically feasible as well as in cases that require evaluation of the full extent and distribution of disease because it can provide a comprehensive evaluation of the entire skeleton. US Area of Interest Although US may be helpful in detecting regional soft-tissue abnormalities that could explain symptoms, US is quite limited in its ability to evaluate bone. There is no relevant literature regarding the use of US for the evaluation of primary bone tumors in patients with positive localized or regional symptoms and negative radiographs or findings that do not explain symptoms. Variant 3: Suspect primary bone tumor. Benign radiographic features. Not osteoid osteoma. Next imaging study. An asymptomatic benign-appearing lesion on radiographs is usually an incidental finding and typically requires no further imaging evaluation. If the lesion is symptomatic, please consult Variant 2. CT Area of Interest CT is not routinely used in the evaluation of lesions that are definitely benign on radiographs. There is no relevant literature regarding the use of CT in the evaluation of definitely benign primary bone tumors.
Primary Bone Tumors. Although FDG- PET/CT can detect metabolically active tumors, there is no relevant literature regarding the use of FDG-PET/CT in patients with positive localized or regional symptoms and negative radiographs or findings that do not explain symptoms. Bone Scan Whole Body Despite its historical utility in detecting radiographically occult bone abnormalities, studies that are more recent have shown that MRI is superior in this role. A retrospective analysis comparing the sensitivity of MRI and scintigraphy in the detection of malignant bone tumors in 106 patients showed that MRI revealed a focal abnormality compatible with tumor that was occult on scintigraphy in 28% of cases [12]. Although not typically the next imaging study, bone scan remains a viable imaging option in select cases in which MRI is not clinically feasible as well as in cases that require evaluation of the full extent and distribution of disease because it can provide a comprehensive evaluation of the entire skeleton. US Area of Interest Although US may be helpful in detecting regional soft-tissue abnormalities that could explain symptoms, US is quite limited in its ability to evaluate bone. There is no relevant literature regarding the use of US for the evaluation of primary bone tumors in patients with positive localized or regional symptoms and negative radiographs or findings that do not explain symptoms. Variant 3: Suspect primary bone tumor. Benign radiographic features. Not osteoid osteoma. Next imaging study. An asymptomatic benign-appearing lesion on radiographs is usually an incidental finding and typically requires no further imaging evaluation. If the lesion is symptomatic, please consult Variant 2. CT Area of Interest CT is not routinely used in the evaluation of lesions that are definitely benign on radiographs. There is no relevant literature regarding the use of CT in the evaluation of definitely benign primary bone tumors.