Diffusion-weighted magnetic resonance imaging for the evaluation of musculoskeletal tumors

Conventional MR imaging provides low specificity in the differential diagnosis of musculoskeletal (MSK) tumors and is unable to offer information about the extent of tumoral necrosis and the presence of viable cells, information crucial to assess treatment response and prognosis. Therefore, diffusion-weighted imaging (DWI) is now used with conventional MR imaging to improve diagnostic accuracy and treatment evaluation. This article discusses the technical aspects of DWI, particularly the quantitative and qualitative interpretation of images in MSK tumors. The clinical application of DWI for tumor detection, characterization, differentiation of tumor tissue from others, and assessment of treatment response are emphasized.