An audit of MRI for bone and soft-tissue tumours performed at referral centres

Magnetic resonance imaging (MRI) is essential in the pre-operative staging of suspected primary bone and soft-tissue sarcomas. Such lesions are ideally managed in specialist centres but it is becoming increasingly common for patients to undergo MRI before referral. The aim of this study was to assess the adequacy of such studies.

Fifty patients (30 men, 20 women; mean age 39 years, range 9-89 years) were included over a 1-year period. Tumours included 31 suspected primary bone tumours and 19 soft-tissue tumours.

The total number of sequences used was 225 (mean 4, range 2-8). Enhancement was used in 19 cases. The commonest mistake was the failure to image the whole bone for 'skip' metastases in 50% of appropriate cases (high-grade malignant lesions of bone). Reports were available in 40 cases. Specific information regarding precise intraosseous and extraosseous extent of tumour and relationship to the neurovascular bundle and adjacent joint was commonly not included.

This audit indicates that a greater awareness is needed amongst general radiologists of the MR imaging and reporting requirements for musculoskeletal tumours. In particular, all important axial imaging is sometimes omitted.Saifuddin, A. (2000). Clinical Radiology 55, 537-541.