Role of CT USG bone scintigraphy PET in the evaluation of musculoskeletal tumors
What is the role of computed tomography (CT), ultrasonography (US), bone scintigraphy, and positron emission tomography/computed tomography (PET/CT) in the evaluation of musculoskeletal tumors?
CT may be helpful to detect the nidus in a suspected osteoid osteoma. CT-guided percutaneous cryoablation has been shown to be an effective treatment of osteoid osteoma. CT is also used for percutaneous image-guided biopsy of bone tumors and in the workup for detection of pulmonary metastases. US offers real-time multiplanar imaging for performing musculoskeletal soft tissue biopsies and can be used to guide the biopsy of a bone lesion with an extraosseous soft tissue component. US may be particularly useful for biopsy of small soft tissue lesions that are difficult to detect on a noncontrast CT and also provides real-time confirmation of needle placement. Technetium-99m ( 99m Tc) methylene diphosphonate (MDP) bone scintigraphy with single photon emission computed tomography (SPECT) is often utilized for the detection of osseous metastases. 18 F-fluorodeoxyglucose (FDG) PET/CT may also be used for the detection of metabolically active soft tissue neoplasms or osseous malignancies. Some studies indicate that 18 F-sodium fluoride (NaF) PET/CT is a potentially superior imaging technique for the detection of osseous metastases.