Are We Heading to the Future of Musculoskeletal Tumor Imaging with Ultra-High Field 7T MRI?

Background and objectives: Sarcoma preoperative planning critically depends on MRI, sometimes uninformative when compartments barriers or critical structures are involved. objective: to prospectively assess the feasibility and the potential of 7T MRI in sarcoma. Methods: Two patients with femoral chondrosarcoma were CT and MRI (1.5 and 7T) scanned with T1W, T2W, GRE and DTI sequences. Image quality and characteristics of the tumors were compared between these modalities. Results: In-plane resolution was higher at 7T as compared to 1.5T MRI, tumor delineation was more reliable and soft tissue involvement was clearer. DT imaging and corresponding ADC mapping allowed a clear distinction between edema and tumor and identified tumor involvement of collateral ligament allowing healthy structures sparing with histopathology confirmation. 7T MRI was also able to define cortical reaction as precisely as CT imaging. Conclusion: Musculoskeletal tumours UHF-MRI is promising. Higher resolution and enhanced signal to noise ratio improved tumoral assessment, infiltration and cortex changes. One could expect this nonradiating technique to replace CT investigation for bone tumours assessment and open new perspectives in the fields of vascular or nerve salvage and response to chemo/radiotherapy. Healthy tissue sparing might be facilitated with impacts on function, complication or reconstruction type.