Spinal and Sacral Chordomas: Overview With Imaging Review.

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Spinal chordomas are rare, aggressive malignant bone tumors arising from notochordal remnants.
• They primarily affect the sacrum, clivus, and spine, presenting diagnostic and therapeutic challenges.
• Similar imaging characteristics to other tumors like chondrosarcomas complicate diagnosis.

Purpose of the Study:

• To review advancements in imaging techniques for spinal chordomas.
• To discuss challenges in diagnosis and their impact on clinical management.
• To highlight the need for improved targeted therapies and imaging for better patient outcomes.

Main Methods:

• Review of current literature on spinal chordoma imaging and molecular characteristics.
• Analysis of diagnostic capabilities of various imaging modalities including MRI, CT, diffusion-weighted imaging, and PET/CT.
• Examination of histological features and the role of the brachyury gene.

Main Results:

• High-resolution MRI and CT improve visualization and surgical planning for spinal chordomas.
• Advanced modalities like diffusion-weighted imaging and PET/CT offer refined diagnostic potential but differentiation remains challenging.
• The brachyury gene is key in chordoma tumorigenesis and a potential therapeutic target.

Conclusions:

• Combining multiple imaging modalities is essential for accurate diagnosis and surgical planning of spinal chordomas.
• Further research into targeted therapies and enhanced imaging techniques is necessary to optimize patient outcomes.
• Addressing diagnostic complexities and improving treatment strategies are critical for managing spinal chordoma recurrence.