Minireviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Mar 28, 2016; 8(3): 268-274
Published online Mar 28, 2016. doi: 10.4329/wjr.v8.i3.268
Utility of positron emission tomography-magnetic resonance imaging in musculoskeletal imaging
Ammar A Chaudhry, Maryam Gul, Elaine Gould, Mathew Teng, Kevin Baker, Robert Matthews
Ammar A Chaudhry, Department of Radiology, Johns Hopkins Medicine, Baltimore, MD 21287, United States
Maryam Gul, Department of Rheumatology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD 20892, United States
Elaine Gould, Mathew Teng, Kevin Baker, Robert Matthews, Department of Radiology, Stony Brook University Hospital, Stony Brook, NY 11794, United States
Author contributions: Chaudhry AA performed majority of the writing; Gul M edited the initial manuscript prior to submission, prepared figures/captions and did literature review for the manuscript; Teng M and Baker K provided input in writing the paper; Gould E (MSK expert) and Matthews R (nuclear medicine expert) had provided the cases and designed the outline and coordinated writing of the paper.
Conflict-of-interest statement: There is no potential conflict of interest. None of the authors in this manuscript received any financial support before or during the production of this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ammar A Chaudhry, MD, Department of Radiology, Johns Hopkins Medicine, 601 North Wolfe Street, Phipps B-100, Baltimore, MD 21287, United States. achaud23@jhmi.edu
Telephone: +1-646-3881995 Fax: +1-410-6141213
Received: September 15, 2015
Peer-review started: September 17, 2015
First decision: October 30, 2015
Revised: November 16, 2015
Accepted: January 8, 2016
Article in press: January 11, 2016
Published online: March 28, 2016
Processing time: 187 Days and 21.4 Hours
Abstract

Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging (MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still has several key limitations which require supplemental information from additional modalities to complete evaluation of various disorders. This has led to the development hybrid positron emission tomography (PET)-MRI which is rapidly evolving to address key clinical questions by using the morphological strengths of MRI and functional information of PET imaging. In this article, we aim to review physical principles and techniques of PET-MRI and discuss clinical utility of functional information obtained from PET imaging and structural information obtained from MRI imaging for the evaluation of musculoskeletal pathology. More specifically, this review highlights the role of PET-MRI in musculoskeletal oncology including initial diagnosis and staging, treatment planning and post-treatment follow-up. Also we will review utility of PET-MRI in evaluating musculoskeletal infections (especially in the immunocompromised and diabetics) and inflammatory condition. Additionally, common pitfalls of PET-MRI will be addressed.

Keywords: Magnetic resonance imaging; Osteosarcoma; Positron emission tomography-magnetic resonance imaging; Osteomyelitis; Positron emission tomography-computed tomography; Positron emission tomography; Multiple myeloma; Lymphoma

Core tip: Positron emission tomography-magnetic resonance imaging is a rapidly emerging technique which provides detailed anatomic and functional imaging simultaneously and allows for differentiation of neoplastic from non-neoplastic conditions. This modality can prove to be both time and cost effective means of evaluating complex cases in patients with coexisting neoplastic, infectious and/or inflammatory conditions. Additional benefits include reducing radiation exposure in patient cohort who is likely to undergo multiple radiologic evaluation over their life time for follow-up.