MR Imaging of Chondrogenic Tumors: Update on Select Imaging Challenges

Abstract

Purpose of Review

This review article discusses the updated World Health Classification of chondrogenic skeletal tumors and the role of conventional and advanced magnetic resonance (MR) imaging in the evaluation of chondrogenic skeletal lesions with emphasis on select diagnostic dilemmas.

Recent Findings

The majority of benign chondrogenic skeletal lesions have typical radiographic and MR features. Conventional MR imaging sequences can be helpful in the distinction of tumor-like lesions from chondrogenic tumors, and the evaluation of anatomic extent, particularly with regard to the detection of soft tissue masses associated with a chondrosarcoma (CS). Benign, atypical, and malignant chondrogenic lesions can have overlapping features on diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping although dynamic contrast-enhanced (DCE) sequences can be helpful in the characterization of chondrogenic tumors as benign or malignant. Patients with multiple chondrogenic tumor conditions or syndromes are predisposed to developing CS and extra-skeletal malignancies, and as such, a small subset may benefit from imaging surveillance.

Summary

The majority of chondrogenic skeletal lesions can be characterized confidently on imaging. In the small subset of intermediate and malignant chondrogenic lesions with overlapping imaging and pathological features, a multidisciplinary approach should be used.