The recommendations contained herein are based on assessment of the available literature and on the experience of the members of the ACR Appropriateness Criteria Expert Panel on Musculoskeletal Imaging. This document applies to the evaluation of osseous lesions throughout the entire body. Generally, bone tumors are most common in the long bones [1], and consequently, recommendations for imaging are for the most part based on this. When lesions occur in locations with complex osseous anatomy, such as the skull, spine, pelvis, or small bones of the hand or foot, CT may be a more suitable initial imaging modality. Similarly, when a lesion occurs in a rib or area in which respiratory motion can be an issue, MRI may not be a suitable imaging modality. As noted within the document, the following recommendations must be adapted by the user, based on lesion size, location, and suspected biological aggressiveness. aResearch Author, Mayo Clinic, Jacksonville, Florida. bPanel Vice-Chair, Mayo Clinic, Jacksonville, Florida. cPanel Chair, University of Kentucky, Lexington, Kentucky. dUK Healthcare Spine and Total Joint Service, Lexington, Kentucky; American Academy of Orthopaedic Surgeons. eRadiology Imaging Associates, Denver, Colorado. fDiagnostic Imaging Associates, Chesterfield, Missouri. gWake Forest University School of Medicine, Winston Salem, North Carolina. hDavid Geffen School of Medicine at UCLA, Los Angeles, California. iUniversity of Virginia, Charlottesville, Virginia. jMayo Clinic Florida, Jacksonville, Florida. kUniversity Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio; Neurosurgery Expert. lOregon Health & Science University, Portland, Oregon; Neurosurgery Expert. mPenn State Milton S. Hershey Medical Center, Hershey, Pennsylvania and Uniformed Services University of the Health Sciences, Bethesda, Maryland. nNuclear Radiologist, Weston, Connecticut. oSpecialty Chair, Mayo Clinic, Phoenix, Arizona.
Primary Bone Tumors. The recommendations contained herein are based on assessment of the available literature and on the experience of the members of the ACR Appropriateness Criteria Expert Panel on Musculoskeletal Imaging. This document applies to the evaluation of osseous lesions throughout the entire body. Generally, bone tumors are most common in the long bones [1], and consequently, recommendations for imaging are for the most part based on this. When lesions occur in locations with complex osseous anatomy, such as the skull, spine, pelvis, or small bones of the hand or foot, CT may be a more suitable initial imaging modality. Similarly, when a lesion occurs in a rib or area in which respiratory motion can be an issue, MRI may not be a suitable imaging modality. As noted within the document, the following recommendations must be adapted by the user, based on lesion size, location, and suspected biological aggressiveness. aResearch Author, Mayo Clinic, Jacksonville, Florida. bPanel Vice-Chair, Mayo Clinic, Jacksonville, Florida. cPanel Chair, University of Kentucky, Lexington, Kentucky. dUK Healthcare Spine and Total Joint Service, Lexington, Kentucky; American Academy of Orthopaedic Surgeons. eRadiology Imaging Associates, Denver, Colorado. fDiagnostic Imaging Associates, Chesterfield, Missouri. gWake Forest University School of Medicine, Winston Salem, North Carolina. hDavid Geffen School of Medicine at UCLA, Los Angeles, California. iUniversity of Virginia, Charlottesville, Virginia. jMayo Clinic Florida, Jacksonville, Florida. kUniversity Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio; Neurosurgery Expert. lOregon Health & Science University, Portland, Oregon; Neurosurgery Expert. mPenn State Milton S. Hershey Medical Center, Hershey, Pennsylvania and Uniformed Services University of the Health Sciences, Bethesda, Maryland. nNuclear Radiologist, Weston, Connecticut. oSpecialty Chair, Mayo Clinic, Phoenix, Arizona.