Comparative role of CT scan and MR imaging in primary malignant bone tumors

o To discuss the role of C.T. scan and M.R.I. in evaluation of primary malignant bone tumors. o To determine the imaging characteristics of different primary malignant bone tumors. o To correlate imaging with surgical and histological findings. Materials and methods: This prospective study of 13 cases was conducted in Shri M. P. Shah Medical College and G.G .Hospital, Jamnagar. Observations: A total of 13 patients with primary malignant bone tumors were evaluated primarily with plain radiography followed by C.T. scan and M.R.I .Contrast study was performed as and when deemed necessary. Following observations were made: There were 4 cases of Ewing's sarcoma, 5 cases of osteosarcoma, a single case of eachbone lymphoma, malignant haemangioendothelioma, malignant giant cell tumor and chondrosarcoma. CT scan was better than MRI in evaluation of cortical destruction in 2 cases and both were equally efficient in 10 cases. Matrix mineralization was present in 5 cases and CT scan detected it with higher accuracy.MRI was better for evaluation of extent of bone marrow involvement in 5 cases and equal to CT scan in 5 cases. The soft tissue extent of tumor was better evaluated with MRI in 7 cases and both modalities were equally good in 6 cases. Joint involvement was present in 4 cases and was better evaluated with MRI in all of them.MRI was superior in evaluation of neurovascular bundle in 9 cases and equal to CT in 4 cases. Although MRI could demonstrate different components of tumor, there was no difference in signal intensity patterns of different histological types of tumors. Conclusions: MRI is the preferred modality to image musculoskeletal tumors and should be obtained after radiographic evaluation. Its multiplanar imaging capability helps delineation of tumor and its extent in bone and soft tissues with high contrast resolution. It is an excellent modality to determine neurovascular bundle involvement, joint involvement, local extent and staging.