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ARRS Meeting 2001 -> May 2^nd

101st American Roentgen Ray Society Meeting: May 2nd
reported by Joseph Gagliardi, M.D.

Scientific Session 16, Musculoskeletal 4: Tumors and Infection was a longer, one hour collection of works that I will highlight. Paper 121] Whole Body MRI for Metastasis Screening. R. Douglas and colleagues (Wake Radiology and Carraway Methodist Hospital) reported that, in their experience, axial and coronal MR imaging has equal sensitivity to bone scans in detecting skeletal metastases as well as providing additional information regarding the presence of visceral lesions.

Paper 122. Skeletal Muscle Metastases at Sites of Previously Documented Trauma
T. Magee and colleagues (Menorah Medical Center) found that, although metastatic lesions to muscles are rare, trauma to the muscle may somehow alter the physiology of the muscles thus allowing for tumor implants. All of the cases reported had a single muscle focus as the initial presentation for metastatic disease.

Paper 123. Advanced Imaging Features of Metastatic Carcinoma to the Soft Tissue and Skeletal Muscle
L. Holmgren and colleagues from the A. F. I. P., and multiple institutions found that, when skeletal metastases develop, there is no predilection for any one muscle. Lung and GI tract tumors account for most primary lesions and the average size is approx. 6 X 9cm. Most have poorly defined margins with enhancement following contrast on cross sectional imaging.

Paper 124. (F-18) Fluoro-2-Deoxy-D-Glucose PET Scanning Efficacy in Evaluating Primary Musculoskeletal Lesions
F. Feldman and colleagues (Columbia Presbyterian Medical Center) showed compelling examples of how PET imaging can be used for problematic lesions. Furthermore, PET can be helpful in biopsy guidance and metastatic screening as well as in post-treatment response.

Papers 126, 127 and 128, all presented by W. Morrison and colleagues (Thomas Jefferson University) evaluated foot infection entities and reported a variety of interesting findings. Fascial borders in the foot, unlike the hand, do not inhibit the spread of infection. Abscess formation is most common in the forefoot and is typically associated with an ulcer. Ulcers and septic arthritis are most commonly found in the forefoot region, particularly at the heads of the first and fifth metatarsals or first and fifth metatarsal joints, respectively. Osteomyelitis and septic joints almost always are in the same location.

Paper 129. Synthesis and Characterization of Dextran-Gadolinium Conjugates as MR Contrast Agents for Infection Imaging
R. Prasad and colleagues provided a thought provoking presentation on molecular MR imaging using macromolecules that remain intravascular and deposit at sites of infection. This technique shows promise and his images were impressive.

Paper 130. MR Imaging of Non-Enhancing Osteomyelitis: Frequency and Patterns was presented by S. Viswamitra and colleagues again examined foot infection. They found that areas of non-enhancement in patients with osteomyelitis are due to abscess fluid, sequestrum formation, devitalized tissue, or, least commonly, necrotic tissue.