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Semin Musculoskelet Radiol 2013; 17(02): 203-220
DOI: 10.1055/s-0033-1343097
DOI: 10.1055/s-0033-1343097
Primary Osseous Tumors of the Spine
Further Information
Publication History
Publication Date:
14 May 2013 (online)
![](https://www.thieme-connect.de/media/smr/201302/lookinside/thumbnails/10.1055-s-0033-1343097-1.jpg)
Abstract
Primary osseous spinal tumors are relatively rare in comparison with metastatic disease, myeloma, and lymphoma. Despite their rarity, the interpreting radiologist must be aware of the typical imaging features to provide appropriate diagnosis for guidance of clinical management. The age of occurrence, distribution longitudinally in the spine, and distribution axially within the vertebra combined with typical imaging appearances can help indicate the correct diagnosis. This article reviews the diagnostic features of benign and malignant primary bone spinal tumors.
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References
- 1 Kelley SP, Ashford RU, Rao AS, Dickson RA. Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry. Eur Spine J 2007; 16 (3) 405-409
- 2 Unni KK, Inwards CY. Mayo Foundation for Medical Education and Research. Dahlin's Bone Tumors: General Aspects and Data on 10,165 cases. 6th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. :vii
- 3 Weinstein JN, McLain RF. Primary tumors of the spine. Spine 1987; 12 (9) 843-851
- 4 Kwon JW, Chung HW, Cho EY , et al. MRI findings of giant cell tumors of the spine. AJR Am J Roentgenol 2007; 189 (1) 246-250
- 5 Boriani S, De Iure F, Campanacci L , et al. Aneurysmal bone cyst of the mobile spine: report on 41 cases. Spine 2001; 26 (1) 27-35
- 6 Ozaki T, Flege S, Liljenqvist U , et al. Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. Cancer 2002; 94 (4) 1069-1077
- 7 Ilaslan H, Sundaram M, Unni KK, Dekutoski MB. Primary Ewing's sarcoma of the vertebral column. Skeletal Radiol 2004; 33 (9) 506-513
- 8 Kroon HM, Schurmans J. Osteoblastoma: clinical and radiologic findings in 98 new cases. Radiology 1990; 175 (3) 783-790
- 9 McLain RW, Weinstein JN. Primary tumors of the spine. Iowa Orthop J 1987; 7: 32-38
- 10 Beer SJ, Menezes AH. Primary tumors of the spine in children. Natural history, management, and long-term follow-up. Spine 1997; 22 (6) 649-658 ; discussion 658–659
- 11 Davies A, Saifuddin A. Imaging of painful scoliosis. Skeletal Radiol 2009; 38 (3) 207-223
- 12 Llauger J, Palmer J, Amores S, Bagué S, Camins A. Primary tumors of the sacrum: diagnostic imaging. AJR Am J Roentgenol 2000; 174 (2) 417-424
- 13 Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980; (153) 106-120
- 14 Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res 1986; (204) 9-24
- 15 Hart RA, Boriani S, Biagini R, Currier B, Weinstein JN. A system for surgical staging and management of spine tumors. A clinical outcome study of giant cell tumors of the spine. Spine 1997; 22 (15) 1773-1782 , discussion 1783
- 16 Boriani S, Weinstein JN, Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine 1997; 22 (9) 1036-1044
- 17 Chan P, Boriani S, Fourney DR , et al. An assessment of the reliability of the Enneking and Weinstein-Boriani-Biagini classifications for staging of primary spinal tumors by the Spine Oncology Study Group. Spine 2009; 34 (4) 384-391
- 18 Lodwick GS, Wilson AJ, Farrell C, Virtama P, Dittrich F. Determining growth rates of focal lesions of bone from radiographs. Radiology 1980; 134 (3) 577-583
- 19 Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg 1993; 78 (1) 36-45
- 20 Barzin M, Maleki I. Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran. Pak J Biol Sci 2009; 12 (6) 542-544
- 21 Laredo JD, Reizine D, Bard M, Merland JJ. Vertebral hemangiomas: radiologic evaluation. Radiology 1986; 161 (1) 183-189
- 22 Healy M, Herz DA, Pearl L. Spinal hemangiomas. Neurosurgery 1983; 13 (6) 689-691
- 23 Ross JS, Masaryk TJ, Modic MT, Carter JR, Mapstone T, Dengel FH. Vertebral hemangiomas: MR imaging. Radiology 1987; 165 (1) 165-169
- 24 Baudrez V, Galant C, Vande Berg BC. Benign vertebral hemangioma: MR-histological correlation. Skeletal Radiol 2001; 30 (8) 442-446
- 25 Laredo JD, Assouline E, Gelbert F, Wybier M, Merland JJ, Tubiana JM. Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology 1990; 177 (2) 467-472
- 26 Long SS, Yablon CM, Eisenberg RL. Bone marrow signal alteration in the spine and sacrum. AJR Am J Roentgenol 2010; 195 (3) W178-200
- 27 Yapar AF, Yapar Z, Kibar M, Barutcu O, Akpinar S. Incidental detection of a vertebral body hemangioma on three-phase bone scintigraphy. Clin Nucl Med 1999; 24 (12) 999-1001
- 28 Choi YY, Seong JY, Yang SO, Lee SR, Cho S. Tc-99m RBC SPECT demonstrating vertebral hemangioma. Clin Nucl Med 1998; 23 (9) 632-634
- 29 Hurley MC, Gross BA, Surdell D , et al. Preoperative Onyx embolization of aggressive vertebral hemangiomas. AJNR Am J Neuroradiol 2008; 29 (6) 1095-1097
- 30 Berkefeld J, Scale D, Kirchner J, Heinrich T, Kollath J. Hypervascular spinal tumors: influence of the embolization technique on perioperative hemorrhage. AJNR Am J Neuroradiol 1999; 20 (5) 757-763
- 31 Acosta Jr FL, Dowd CF, Chin C, Tihan T, Ames CP, Weinstein PR. Current treatment strategies and outcomes in the management of symptomatic vertebral hemangiomas. Neurosurgery 2006; 58 (2) 287-295 , discussion 287–295
- 32 Gold RH, Mirra JM, Remotti F, Pignatti G. Case report 527: Giant bone island of tibia. Skeletal Radiol 1989; 18 (2) 129-132
- 33 Greenspan A, Steiner G, Knutzon R. Bone island (enostosis): clinical significance and radiologic and pathologic correlations. Skeletal Radiol 1991; 20 (2) 85-90
- 34 Greenspan A. Bone island (enostosis): current concept—a review. Skeletal Radiol 1995; 24 (2) 111-115
- 35 Kim JH, Kim JI, Jang BH, Seo JG, Kim JH. The comparison of bone scan and MRI in osteoporotic compression fractures. Asian Spine J 2010; 4 (2) 89-95
- 36 Murphey MD, Flemming DJ, Boyea SR, Bojescul JA, Sweet DE, Temple HT. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. Radiographics 1998; 18 (5) 1213-1237 ; quiz 1244–1245
- 37 Onitsuka H. Roentgenologic aspects of bone islands. Radiology 1977; 123 (3) 607-612
- 38 Mirra JM, Ulich T, Magidson J, Kaiser L, Eckardt J, Gold R. A case of probable benign pulmonary “metastases” or implants arising from a giant cell tumor of bone. Clin Orthop Relat Res 1982; (162) 245-254
- 39 Greenspan A, Stadalnik RC. Bone island: scintigraphic findings and their clinical application. Can Assoc Radiol J 1995; 46 (5) 368-379
- 40 Jackson RP, Reckling FW, Mants FA. Osteoid osteoma and osteoblastoma. Similar histologic lesions with different natural histories. Clin Orthop Relat Res 1977; (128) 303-313
- 41 Gamba JLM, Martinez S, Apple J, Harrelson JM, Nunley JA. Computed tomography of axial skeletal osteoid osteomas. AJR Am J Roentgenol 1984; 142 (4) 769-772
- 42 Kransdorf MJ, Stull MA, Gilkey FW, Moser Jr RP. Osteoid osteoma. Radiographics 1991; 11 (4) 671-696
- 43 Greenspan A. Benign bone-forming lesions: osteoma, osteoid osteoma, and osteoblastoma. Clinical, imaging, pathologic, and differential considerations. Skeletal Radiol 1993; 22 (7) 485-500
- 44 Strach EH. Osteoid osteoma. BMJ 1953; 1 (4818) 1031
- 45 Saifuddin A, White J, Sherazi Z, Shaikh MI, Natali C, Ransford AO. Osteoid osteoma and osteoblastoma of the spine. Factors associated with the presence of scoliosis. Spine 1998; 23 (1) 47-53
- 46 Helms CA. Osteoid osteoma. The double density sign. Clin Orthop Relat Res 1987; (222) 167-173
- 47 Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrrell PN. The diagnostic accuracy of MR imaging in osteoid osteoma. Skeletal Radiol 2002; 31 (10) 559-569
- 48 Rybak LD, Gangi A, Buy X, La Rocca Vieira R, Wittig J. Thermal ablation of spinal osteoid osteomas close to neural elements: technical considerations. AJR Am J Roentgenol 2010; 195 (4) W293-W298
- 49 McLeod RA, Dahlin DC, Beabout JW. The spectrum of osteoblastoma. AJR Am J Roentgenol 1976; 126 (2) 321-325
- 50 Nemoto O, Moser Jr RP, Van Dam BE, Aoki J, Gilkey FW. Osteoblastoma of the spine. A review of 75 cases. Spine 1990; 15 (12) 1272-1280
- 51 Schajowicz F, Lemos C. Osteoid osteoma and osteoblastoma. Closely related entities of osteoblastic derivation. Acta Orthop Scand 1970; 41 (3) 272-291
- 52 Lucas DR, Unni KK, McLeod RA, O'Connor MI, Sim FH. Osteoblastoma: clinicopathologic study of 306 cases. Hum Pathol 1994; 25 (2) 117-134
- 53 Shaikh MI, Saifuddin A, Pringle J, Natali C, Sherazi Z. Spinal osteoblastoma: CT and MR imaging with pathological correlation. Skeletal Radiol 1999; 28 (1) 33-40
- 54 Berry M, Mankin H, Gebhardt M, Rosenberg A, Hornicek F. Osteoblastoma: a 30-year study of 99 cases. J Surg Oncol 2008; 98 (3) 179-183
- 55 Merryweather R, Middlemiss JH, Sanerkin NG. Malignant transformation of osteoblastoma. J Bone Joint Surg Br 1980; 62-B (3) 381-384
- 56 Sanjay BK, Sim FH, Unni KK, McLeod RA, Klassen RA. Giant-cell tumours of the spine. J Bone Joint Surg Br 1993; 75 (1) 148-154
- 57 Werner M. Giant cell tumour of bone: morphological, biological and histogenetical aspects. Int Orthop 2006; 30 (6) 484-489
- 58 Bidwell JK, Young JW, Khalluff E. Giant cell tumor of the spine: computed tomography appearance and review of the literature. J Comput Tomogr 1987; 11 (3) 307-311
- 59 Komiya S, Zenmyo M, Inoue A. Bone tumors in the pelvis presenting growth during pregnancy. Archives of orthopaedic and traumatic surgery. Arch Orthop Unfallchir 1999; 119: 22-29
- 60 Boriani S, Sudanese A, Baldini N, Picci P. Sarcomatous degeneration of giant cell tumours. Ital J Orthop Traumatol 1986; 12 (2) 191-199
- 61 Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum. Clin Orthop Relat Res 1993; 291 (291) 215-221
- 62 Tubbs WS, Brown LR, Beabout JW, Rock MG, Unni KK. Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol 1992; 158 (2) 331-334
- 63 Donthineni R, Boriani L, Ofluoglu O, Bandiera S. Metastatic behaviour of giant cell tumour of the spine. Int Orthop 2009; 33 (2) 497-501
- 64 Disler DGM, Miklic D. Imaging findings in tumors of the sacrum. AJR Am J Roentgenol 1999; 173 (6) 1699-1706
- 65 Hudson TM, Schiebler M, Springfield DS, Enneking WF, Hawkins Jr IF, Spanier SS. Radiology of giant cell tumors of bone: computed tomography, arthro-tomography, and scintigraphy. Skeletal Radiol 1984; 11 (2) 85-95
- 66 Murphey MD, Nomikos GC, Flemming DJ , et al. From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation. Radiographics 2001; 21 (5) 1283-1309
- 67 Levine E, De Smet AA, Neff JR, Martin NL. Scintigraphic evaluation of giant cell tumor of bone. AJR Am J Roentgenol 1984; 143 (2) 343-348
- 68 Bergh P, Kindblom LG, Gunterberg B, Remotti F, Ryd W, Meis-Kindblom JM. Prognostic factors in chordoma of the sacrum and mobile spine: a study of 39 patients. Cancer 2000; 88 (9) 2122-2134
- 69 Fourney DR, Rhines LD, Hentschel SJ , et al. En bloc resection of primary sacral tumors: classification of surgical approaches and outcome. J Neurosurg Spine 2005; 3 (2) 111-122
- 70 Martin C, McCarthy EF. Giant cell tumor of the sacrum and spine: series of 23 cases and a review of the literature. Iowa Orthop J 2010; 30: 69-75
- 71 Devin C, Chong PY, Holt GE , et al. Level-adjusted perioperative risk of sacral amputations. J Surg Oncol 2006; 94 (3) 203-211
- 72 Tang X, Guo W, Yang R, Tang S, Ji T. Risk factors for blood loss during sacral tumor resection. Clin Orthop Relat Res 2009; 467 (6) 1599-1604
- 73 Balke M, Campanacci L, Gebert C , et al. Bisphosphonate treatment of aggressive primary, recurrent and metastatic giant cell tumour of bone. BMC Cancer 2010; 10: 462
- 74 Thomas DM. RANKL, denosumab, and giant cell tumor of bone. Curr Opin Oncol 2012; 24 (4) 397-403
- 75 Thomas DM, Skubitz KM. Giant cell tumour of bone. Curr Opin Oncol 2009; 21 (4) 338-344
- 76 Gille O, Oliveira BdeA, Guerin P, Lepreux S, Richez C, Vital JM. Regression of giant cell tumor of the cervical spine with bisphosphonate as single therapy. Spine 2012; 37 (6) E396-E399
- 77 Lau CP, Huang L, Tsui SK, Ng PK, Leung PY, Kumta SM. Pamidronate, farnesyl transferase, and geranylgeranyl transferase-I inhibitors affects cell proliferation, apoptosis, and OPG/RANKL mRNA expression in stromal cells of giant cell tumor of bone. J Orthop Res 2011; 29 (3) 403-413
- 78 Vergel De Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK. Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer 1992; 69 (12) 2921-2931
- 79 Sundaresan N. American Association of Neurological Surgeons. Tumors of the Spine: Diagnosis and Clinical Management. Philadelphia, PA: Saunders; 1990: xix
- 80 Mirra JM, Picci P, Gold RH. Bone Tumors: Clinical, Radiologic, and Pathologic Correlations. Philadelphia, PA: Lea & Febiger; 1989
- 81 Ruiter DJ, van Rijssel TG, van der Velde EA. Aneurysmal bone cysts: a clinicopathological study of 105 cases. Cancer 1977; 39 (5) 2231-2239
- 82 Kransdorf MJ, Sweet DE. Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging. AJR Am J Roentgenol 1995; 164 (3) 573-580
- 83 de Kleuver M, van der Heul RO, Veraart BE. Aneurysmal bone cyst of the spine: 31 cases and the importance of the surgical approach. J Pediatr Orthop B 1998; 7 (4) 286-292
- 84 Mankin HJ, Hornicek FJ, Ortiz-Cruz E, Villafuerte J, Gebhardt MC. Aneurysmal bone cyst: a review of 150 patients. J Clin Oncol 2005; 23 (27) 6756-6762
- 85 Beltran J, Simon DC, Levy M, Herman L, Weis L, Mueller CF. Aneurysmal bone cysts: MR imaging at 1.5 T. Radiology 1986; 158 (3) 689-690
- 86 Mahnken AH, Nolte-Ernsting CC, Wildberger JE , et al. Aneurysmal bone cyst: value of MR imaging and conventional radiography. Eur Radiol 2003; 13 (5) 1118-1124
- 87 Bonakdarpour A, Levy WM, Aegerter E. Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases. Radiology 1978; 126 (1) 75-83
- 88 Liu JK, Brockmeyer DL, Dailey AT, Schmidt MH. Surgical management of aneurysmal bone cysts of the spine. Neurosurg Focus 2003; 15 (5) E4
- 89 Koci TM, Mehringer CM, Yamagata N, Chiang F. Aneurysmal bone cyst of the thoracic spine: evolution after particulate embolization. AJNR Am J Neuroradiol 1995; 16 (4) (, Suppl) 857-860
- 90 Dahlin DC, Unni KK. Bone Tumors: General Aspects and Data on 8,542 Cases. 4th ed. Springfield, IL: Thomas; 1986: xv
- 91 Schajowicz F. Tumors and Tumor-Like Lesions of Bone and Joints. New York, NY: Springer-Verlag; 1981: xiv
- 92 Jaffe N, Ried HL, Cohen M, McNeese MD, Sullivan MP. Radiation induced osteochondroma in long-term survivors of childhood cancer. Int J Radiat Oncol Biol Phys 1983; 9 (5) 665-670
- 93 Libshitz HI, Cohen MA. Radiation-induced osteochondromas. Radiology 1982; 142 (3) 643-647
- 94 Soloman L. Hereditary multiple exostosis. J Bone Joint Surg Br 1963; 45 (2) 292-304
- 95 Albrecht S, Crutchfield JS, SeGall GK. On spinal osteochondromas. J Neurosurg 1992; 77 (2) 247-252
- 96 Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics 2000; 20 (5) 1407-1434
- 97 Recht MP, Goodwin DW, Winalski CS, White LM. MRI of articular cartilage: revisiting current status and future directions. AJR Am J Roentgenol 2005; 185 (4) 899-914
- 98 Bernard SA, Murphey MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology 2010; 255 (3) 857-865
- 99 Murphey MD, Andrews CL, Flemming DJ, Temple HT, Smith WS, Smirniotopoulos JG. From the archives of the AFIP. Primary tumors of the spine: radiologic-pathologic correlation. Radiographics 1996; 16: 1131-1158
- 100 Chugh R, Tawbi H, Lucas DR, Biermann JS, Schuetze SM, Baker LH. Chordoma: the nonsarcoma primary bone tumor. Oncologist 2007; 12 (11) 1344-1350
- 101 Smith JL, Ludwig RL, Marcove RC. Sacrococcygeal chordoma. A clinicoradiological study of 60 patients. Skeletal Radiol 1987; 16 (1) 37-44
- 102 Sung MS, Lee GK, Kang HS , et al. Sacrococcygeal chordoma: MR imaging in 30 patients. Skeletal Radiol 2005; 34 (2) 87-94
- 103 Smolders D, Wang X, Drevelengas A, Vanhoenacker F, De Schepper AM. Value of MRI in the diagnosis of non-clival, non-sacral chordoma. Skeletal Radiol 2003; 32 (6) 343-350
- 104 de Bruïne FT, Kroon HM. Spinal chordoma: radiologic features in 14 cases. AJR Am J Roentgenol 1988; 150 (4) 861-863
- 105 Boriani S, Bandiera S, Biagini R , et al. Chordoma of the mobile spine: fifty years of experience. Spine 2006; 31 (4) 493-503
- 106 Neeman Z, Patti JW, Wood BJ. Percutaneous radiofrequency ablation of chordoma. AJR Am J Roentgenol 2002; 179 (5) 1330-1332
- 107 Shives TC, McLeod RA, Unni KK, Schray MF. Chondrosarcoma of the spine. J Bone Joint Surg Am 1989; 71 (8) 1158-1165
- 108 York JE, Berk RH, Fuller GN , et al. Chondrosarcoma of the spine: 1954 to 1997. J Neurosurg 1999; 90 (1, Suppl) 73-78
- 109 Strike SA, McCarthy EF. Chondrosarcoma of the spine: a series of 16 cases and a review of the literature. Iowa Orthop J 2011; 31: 154-159
- 110 Lloret I, Server A, Bjerkehagen B. Primary spinal chondrosarcoma: radiologic findings with pathologic correlation. Acta Radiol 2006; 47 (1) 77-84
- 111 Hirsh LF, Thanki A, Spector HB. Primary spinal chondrosarcoma with eighteen-year follow-up: case report and literature review. Neurosurgery 1984; 14 (6) 747-749
- 112 Desai SS, Jambhekar NA. Pathology of Ewing's sarcoma/PNET: current opinion and emerging concepts. Indian J Orthop 2010; 44 (4) 363-368
- 113 Papagelopoulos PJ, Currier BL, Galanis E, Grubb MJ, Pritchard DJ, Ebersold MJ. Vertebra plana caused by primary Ewing sarcoma: case report and review of the literature. J Spinal Disord Tech 2002; 15 (3) 252-257
- 114 Cotterill SJ, Ahrens S, Paulussen M , et al. Prognostic factors in Ewing's tumor of bone: analysis of 975 patients from the European Intergroup Cooperative Ewing's Sarcoma Study Group. J Clin Oncol 2000; 18 (17) 3108-3114
- 115 Bacci G, Longhi A, Ferrari S, Mercuri M, Versari M, Bertoni F. Prognostic factors in non-metastatic Ewing's sarcoma tumor of bone: an analysis of 579 patients treated at a single institution with adjuvant or neoadjuvant chemotherapy between 1972 and 1998. Acta Oncol 2006; 45 (4) 469-475
- 116 Rodríguez-Galindo C, Liu T, Krasin MJ , et al. Analysis of prognostic factors in Ewing sarcoma family of tumors: review of St. Jude Children's Research Hospital studies. Cancer 2007; 110 (2) 375-384
- 117 Bacci G, Boriani S, Balladelli A , et al. Treatment of nonmetastatic Ewing's sarcoma family tumors of the spine and sacrum: the experience from a single institution. Eur Spine J 2009; 18 (8) 1091-1095
- 118 Esiashvili N, Goodman M, Marcus Jr RB. Changes in incidence and survival of Ewing sarcoma patients over the past 3 decades: Surveillance Epidemiology and End Results data. J Pediatr Hematol Oncol 2008; 30 (6) 425-430
- 119 Meyer JS, Nadel HR, Marina N , et al. Imaging guidelines for children with Ewing sarcoma and osteosarcoma: a report from the Children's Oncology Group Bone Tumor Committee. Pediatr Blood Cancer 2008; 51 (2) 163-170
- 120 Leavey PJ, Mascarenhas L, Marina N , et al; Children's Oncology Group. Prognostic factors for patients with Ewing sarcoma (EWS) at first recurrence following multi-modality therapy: a report from the Children's Oncology Group. Pediatr Blood Cancer 2008; 51 (3) 334-338
- 121 Treglia G, Salsano M, Stefanelli A, Mattoli MV, Giordano A, Bonomo L. Diagnostic accuracy of. 18F-FDG-PET and PET/CT in patients with Ewing sarcoma family tumours: a systematic review and a meta-analysis. Skeletal Radiol 2012; 41 (3) 249-256
- 122 Ilaslan H, Sundaram M, Unni KK, Shives TC. Primary vertebral osteosarcoma: imaging findings. Radiology 2004; 230 (3) 697-702
- 123 Shives TC, Dahlin DC, Sim FH, Pritchard DJ, Earle JD. Osteosarcoma of the spine. J Bone Joint Surg Am 1986; 68 (5) 660-668