•To discuss the diagnostic value of the diffusion weighted imaging in characterization of bone and soft tissue tumors •To explain clinical situations that diffusion weighted imaging may be useful •To display diffusion weighted imaging findings of some musculoskeletal tumors and tumor-like lesions •To emphasize its current limitations and future directions

Although magnetic resonance (MR) imaging has an important role in characterization of the bone and soft tissue tumors, it lacks specificity of differentiation benign from malignant lesions (1, 2). Benign lesions are much more common than malignant lesions in daily practice (3). So we still need diagnostic tools that improve our diagnostic confidence and prevent unnecessary biopsies or surgeries. Diffusion weighted (DW) imaging is a noninvasive method for investigation tumor histologic content. It is a diagnostic tool with a very short acquisition time and it...

Imaging technique At our institution, musculoskeletal DW imaging is performed using a 1.5 T system (Achieva, Philips, Best, The Netherlands). An echoplanar sequence is used for diffusion-weighted image acquisition with the following parameters: Repetition time: 4500 ms, echo time: 105 ms, directions of the motion-probing gradients: Three orthogonal axes, b value: 0 and 1000 s/mm2, field of view: 220 mm, matrix size: 128 × 80, section thickness: 5 mm with 0.2 mm intersection gaps and two signals acquired. Parallel imaging techniques, sensitivity encoding with a...

Different tissue contrast of the DW imaging makes it a useful tool for detection and characterization of the musculoskeletal tumors. With morphologic characteristics analyzed using conventional MR imaging, DW imaging is valuable in differentiating these tumors. Addition of this short-time imaging to routine protocols improves our diagnostic confidence and may prevent unnecessary biopsies or surgeries.

Yeliz Pekcevik Izmir Tepecik Training and Research Hospital, Department of Radiology Izmir/Turkey

References: 1. Subhawong TK, Wang X, Durand DJ, et al. Proton MR spectroscopy in metabolic assessment of musculoskeletal lesions. AJR Am J Roentgenol 2012;198:162-72. 2. Gielen JL, De Schepper AM, Vanhoenacker F, et al. Accuracy of MRI in characterization of soft tissue tumors and tumor-like lesions: a prospective study in 548 patients. Eur Radiol 2004;14:2320-30. 3. Damron TA, Beauchamp CP, Rougraff BT, Ward WG Sr. Soft-tissue lumps and bumps. Instr Course Lect 2004;53:625-37. 4. van Rijswijk CS, Kunz P, Hogendoorn PC, Taminiau AH, Doornbos J,...