What does axial skeleton osteosarcoma look like on MRI?

VRU 63(5): 552-562

June 17, 2023

tudy: This is a multicenter, retrospective, case series study that describes the MRI features of histologically confirmed cranial and vertebral osteosarcoma in a population of dogs. The study aims to improve veterinary care by increasing clinical suspicion and informing additional diagnostic testing and therapeutic intervention.

Methods: The study included 35 dogs with cranial or vertebral osteosarcoma from five institutions. MRI studies of these dogs were prospectively scored by consensus of two veterinary radiologists. Recorded characteristics included location, signal intensity, homogeneity, contrast enhancement, margin delineation, local invasion, osteolysis, osteosclerosis, zone of transition, periosteal proliferation, pathological fracture, meningeal/CNS involvement, and presence of metastatic disease.

Results: The results showed that all dogs had signal heterogeneity in T2-weighted (T2W) images and contrast enhancement. Other common findings included osteolysis (n = 34), a soft tissue mass (n = 33), and compression of the brain or spinal cord (n = 33). Other interesting features included periosteal proliferation (n = 18), foci of T1W and T2W hypointensity in the soft tissue mass (n = 14), invasion into adjacent bones (n = 10), pathological fracture (n = 7), regional lymph node changes (n = 6), a diaphragmatic nodule (n = 1), and a lung nodule (n = 1).

Conclusion: The study concludes that cranial and vertebral osteosarcomas had some typical MRI features in this multicenter sample of dogs. Improved awareness of these typical MRI features could be used to help create a prioritized differential diagnosis list. Image evaluators should pay careful attention to the possibility of pathological fractures, invasion into adjacent bones, skip metastases, and evidence of metastasis to the lungs or regional lymph nodes. Biopsy is necessary to confirm the presumptive diagnosis.

Example of vertebral osteosarcoma with typical MRI findings. T2-weighted (T2W) transverse image (A), postcontrast T1-weighted (T1W) sagittal image with fat saturation (B), T1W transverse image (C) and postcontrast T1W transverse image with fat saturation (D). The white line in B denotes the slice position of A, C, and D. This is an 8-year-old castrated male Jack Russell terrier with a 14-day duration of progressive nonambulatory tetraparesis. There is an expansile mass associated with the right body, pedicle, and lamina of the fifth cervical vertebra. The mass causes destruction of cortical and medullary bone with a long zone of transition. Relative to the spinal cord, the mass has high and heterogeneous T1W and T2W signal intensity with strong, heterogeneous contrast enhancement. A soft tissue component of the mass extends into and away from the vertebral canal. It causes compression and displacement of the spinal cord. There is a T1W and T2W hypointense focus in the mass (possible mineral, black arrowhead). There is an edema-like signal (T2W hyperintensity) of the spinal cord gray matter, suggestive of compressive or ischemic myelopathy

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