Pediatric vertebral tumors: radiologic features and differential diagnoses

Area of Science:

• Pediatric oncology
• Radiology
• Spinal surgery

Background:

• Primary vertebral tumors in children are rare but pose risks of neurological compromise and spinal instability.
• These tumors present a diverse histologic range, from benign osteoid osteomas to malignant Ewing sarcomas.
• Accurate and timely diagnosis is critical to prevent irreversible neurological damage.

Purpose of the Study:

• To provide a comprehensive review of pediatric spinal bone tumor classification and imaging characteristics.
• To emphasize the strengths and limitations of various imaging modalities.
• To highlight the expanding role of interventional radiology in diagnosis and treatment.

Main Methods:

• Review of conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI) for pediatric vertebral tumors.
• Discussion of advanced MRI techniques like diffusion-weighted imaging (DWI) and dynamic contrast-enhanced studies.
• Overview of minimally invasive interventional techniques such as image-guided biopsy, radiofrequency ablation, and cryoablation.

Main Results:

• Conventional radiography is a first-line tool but has limited sensitivity for subtle findings.
• CT excels in evaluating cortical integrity and mineralization, aiding in osteoid osteoma diagnosis and treatment planning.
• MRI is the preferred modality for assessing soft tissue, bone marrow, and neural structures, with advanced techniques enhancing characterization.

Conclusions:

• Imaging is fundamental throughout the clinical management of pediatric vertebral tumors.
• Minimally invasive interventional radiology techniques offer expanded therapeutic options, especially for benign lesions.
• This review underscores the importance of tailored imaging approaches and interventional radiology in managing pediatric spinal bone tumors.