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Semin Musculoskelet Radiol 2013; 17(02): 189-202
DOI: 10.1055/s-0033-1343096
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Image-Guided Biopsy and Treatment of Musculoskeletal Tumors

Travis J. Hillen
1   Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Jonathan C. Baker
1   Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Jack W. Jennings
1   Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Daniel E. Wessell
1   Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
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Publication History

Publication Date:
14 May 2013 (online)

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Abstract

This article reviews the basics of image-guided intervention of musculoskeletal neoplasms. Image-guided procedures are playing an ever-increasing role in the diagnosis, staging, and treatment of musculoskeletal tumors. The successful handling of these lesions necessitates a multidisciplinary approach, with the radiologist working closely with the orthopedic oncologic surgeon, medical oncologist, radiation oncologist, and pathologist to ensure that the procedure is performed in a way that maximizes the chance of definitive diagnosis and/or the treatment effect while minimizing potential complications. To accomplish these goals, the radiologist must be familiar with the indications and contraindications for any biopsy or treatment, effective procedure planning (e.g., selection of biopsy path, type of imaging guidance and biopsy needle, etc.), proper specimen handling, and potential treatment options such as thermal ablation or cement augmentation. Continued involvement after the procedure—including follow-up to ensure that pathology is concordant with imaging—is also crucial.

Keywords

biopsy - sarcoma - metastasis - radiofrequency ablation - cryoablation
 

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