Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are commonly used for evaluating musculoskeletal tumors. These are expensive tests, and it is not clear when one procedure may substitute for another or what is the best algorithm for their use. The role of iodinated intravenous contrast (CT) and gadolinium (MRI) is also unclear. Clinical experience suggests that there is a certain amount of duplication in the use of these procedures. This study evaluates the cost and adequacy of the imaging evaluation done prior to arrival in the referral center. CT and MRI scans are then repeated immediately prior to resection of the entire tumor and compared with the pathological specimen. The accuracy, and incremental benefit of intravenous contrast, gadolinium, and multiplanar MR images is evaluated by ROC curves. Tumor volume is measured by various imaging techniques and compared to measurements made by the pathologist, and tumor volume calculations done on digitized photographs of the surgical specimen.
