Our review focused on literature that discusses the relationship of size to an underlying malignancy, and the use of advanced imaging modalities to determine the cause and formulate a treatment plan. There were 5 high and 11 moderate quality studies evaluating the use of MR imaging for a bone or soft tissue tumor of unknown etiology with a mass of a certain size or depth to assist with obtaining a diagnosis or planning further treatment. High strength studies have evaluated the ability of MR imaging to differentiate benign from malignant tumors in a variety of locations in the axial (Matsumoto 2016) and appendicular (Liu 2011) regions and soft tissue masses with a variety of sizes, appearances (cystic or solid [Harish 2006]) and tissue types (fatty [Rougraff 1997], neurogenic [Zhang 2015], etc). Two high quality studies (Matsumoto 2016 and Zhang 2015) and 6 moderate quality studies (Calleja 2012, Chen 2009c, Chung 2012, Datir 2008, Gruber 2016, and Sen 2010) found MRI to have a moderate to strong relationship to histopathological results in determining malignancy of soft tissue tumors with a size of 5cm or larger. MRI is first option for staging malignant bone tumors and for evaluation of all indeterminate soft tissue tumors. Other imaging modalities (CT of the site, PET/CT, Tc 99m Bone Scan) are used in specific cases and should be implemented by, or with the guidance of, the treating oncology team.
- Gruber,L.; Loizides,A.; Luger,A.K.; Glodny,B.; Moser,P.; Henninger,B.; Gruber,H. Soft-Tissue Tumor Contrast Enhancement Patterns: Diagnostic Value and Comparison Between Ultrasound and MRI
- Harish,S.; Lee,J.C.; Ahmad,M.; Saifuddin,A. Soft tissue masses with "cyst-like" appearance on MR imaging: Distinction of benign and malignant lesions
- Matsumoto,Y.; Harimaya,K.; Kawaguchi,K.; Hayashida,M.; Okada,S.; Doi,T.; Iwamoto,Y. Dumbbell Scoring System: A New Method for the Differential Diagnosis of Malignant and Benign Spinal Dumbbell Tumors
- Rougraff,B.T.; Durbin,M.; Lawerence,J.; Buckwalter,K. Histologic correlation with magnetic resonance imaging for benign and malignant lipomatous masses
- Calleja,M.; Dimigen,M.; Saifuddin,A. MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions
- Chung,W.J.; Chung,H.W.; Shin,M.J.; Lee,S.H.; Lee,M.H.; Lee,J.S.; Kim,M.J.; Lee,W.K. MRI to differentiate benign from malignant soft-tissue tumours of the extremities: a simplified systematic imaging approach using depth, size and heterogeneity of signal intensity