Positron emission tomography/magnetic resonance imaging in musculoskeletal benign conditions

A wide spectrum of benign musculoskeletal (orthopedic and rheumatological) conditions affect the general population. Collectively, these are common, and they can inflict significant morbidity with resultant negative impact on the quality of life of patients. For many of these conditions, there is established evidence for research and clinical use of PETCT and MRI for assessment of disease. Introduction of integrated PET/MRI around a decade ago brought optimism that combining the strength of PET and MRI techniques on a single platform could have synergistic effect to benefit imaging assessment of patients, including in the context of benign musculoskeletal conditions. This review specifically focuses on the progress that has been made. This aims to showcase clinical studies derived primarily from the integrated PET/MRI platforms for the evaluation of common orthopedic and rheumatological conditions. Despite enthusiasm and progress by early adopters of the PET/MRI technology, significant barriers are present for its wider adoption, validation, and translation to routine clinical practice. Attenuation correction is a particular challenge which affects regions close to the skeleton and impacts PET/MRI assessment of musculoskeletal disorders. Continued effort on research and validation, as well as promotion of its multimodal multiparametric capability to clinical and pharmaceutical stakeholders, and increased availability through increased adoption of PET/MRI scanners internationally, may accelerate its translation into routine clinical practice in this domain.