In a study of 29 patients assessing the value of PET in appropriately characterizing cartilage neoplasms, the overall sensitivity of PET in differentiating benign from malignant lesions was 90.9%, with a specificity of 100% and accuracy of 96.6% [33]. Bredella et al [26] found Primary Bone Tumors that FDG-PET can help differentiate benign from malignant spinal compression fractures with a sensitivity of 86% and specificity of 83%; however, there was overlap in the range of standardized uptake value in the benign and malignant groups. MRI Area of Interest MRI is a robust tool that can further characterize an indeterminate bone lesion detected on radiographs. Despite its widespread use in this role, there are few controlled studies in the literature over the last 10 years specifically evaluating the role of MRI in further characterizing lesions detected on radiographs. Several studies do exist that serve to highlight the role of MRI in further characterizing the tissue composition (such as fat, hemorrhage, fluid levels) and anatomic extent of a variety of bone tumors [20-22,34,35]. MRI has also been shown to be useful in predicting the grade (benign versus malignant) of known primary bone tumors. A prospective study evaluating 200 consecutive bone tumors of the hand showed that MRI improved grading in comparison with radiography alone by correctly upgrading malignant tumors and downgrading benign tumors in 8% and 12% of cases, respectively [7]. Crim et al [9] performed a retrospective review of 53 cases of low-grade cartilage lesions (enchondroma and grade 1 chondrosarcoma) and found that MRI suggested the correct diagnosis of enchondroma in 57.8% of cases (radiographs correctly diagnosed 67.2% of cases) and the correct diagnosis of chondrosarcoma in 57.8% of cases (radiographs correctly diagnosed 20.8% of cases).
Primary Bone Tumors. In a study of 29 patients assessing the value of PET in appropriately characterizing cartilage neoplasms, the overall sensitivity of PET in differentiating benign from malignant lesions was 90.9%, with a specificity of 100% and accuracy of 96.6% [33]. Bredella et al [26] found Primary Bone Tumors that FDG-PET can help differentiate benign from malignant spinal compression fractures with a sensitivity of 86% and specificity of 83%; however, there was overlap in the range of standardized uptake value in the benign and malignant groups. MRI Area of Interest MRI is a robust tool that can further characterize an indeterminate bone lesion detected on radiographs. Despite its widespread use in this role, there are few controlled studies in the literature over the last 10 years specifically evaluating the role of MRI in further characterizing lesions detected on radiographs. Several studies do exist that serve to highlight the role of MRI in further characterizing the tissue composition (such as fat, hemorrhage, fluid levels) and anatomic extent of a variety of bone tumors [20-22,34,35]. MRI has also been shown to be useful in predicting the grade (benign versus malignant) of known primary bone tumors. A prospective study evaluating 200 consecutive bone tumors of the hand showed that MRI improved grading in comparison with radiography alone by correctly upgrading malignant tumors and downgrading benign tumors in 8% and 12% of cases, respectively [7]. Crim et al [9] performed a retrospective review of 53 cases of low-grade cartilage lesions (enchondroma and grade 1 chondrosarcoma) and found that MRI suggested the correct diagnosis of enchondroma in 57.8% of cases (radiographs correctly diagnosed 67.2% of cases) and the correct diagnosis of chondrosarcoma in 57.8% of cases (radiographs correctly diagnosed 20.8% of cases).