E5044. Review of Spinal Tumors: What the Radiologist Needs to Know
Authors
Adam Patrick;
Baylor Scott and White-; ; Texas A&M School of Medicine
James Murchison-; ;
Baylor Scott and White-; ; Texas A&M School of Medicine
Kyle Thomas-; ;
Baylor Scott and White-; ; Texas A&M School of Medicine
Harold Sonnier-; ;
Baylor Scott and White-; ; Texas A&M School of Medicine
Robert Smith-; ;
Baylor Scott and White-; ; Texas A&M School of Medicine
Background
Spinal tumors encompass a wide range of pathology, due to the varied embryologic etiology and histology present. This can lead to confusion and uncertainty among radiologists, particularly those that are not trained neuroradiologists. We present a review of the most common spinal tumors divided into extradural, intradural extramedullary, and intramedullary categories, along with case examples and important differential considerations. In addition, we also review the information that needs to be provided in the radiology report to clinicians to appropriately manage spinal tumors. This includes the NOMS (neurologic, oncologic, mechanical, and systemic) framework with epidural spinal cord compression (ESCC) scoring and the independent spinal instability neoplastic score (SINS).
Educational Goals / Teaching Points
1. Review most common spinal tumors within the extradural, intradural extramedullary, and intramedullary locations. 2. Provide focused differential diagnosis for tumors in each location through representative case examples. 3. Evaluation of the NOMS framework and required imaging CT and MRI protocols for spinal tumors. 4. Understand ESCC and SINS scoring with template suggestions for incorporation into the radiology report.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Due to the complex and varied pathology involved with spinal tumors, appropriate imaging, as well as documentation of findings, can be challenging for the radiologist. Review of CT and MRI of the most common spinal tumors with associated differential diagnoses will aid understanding. In addition, use of standard report templates can aid radiologists in the incorporation of the NOMS framework with ESCC scoring and the independent SINS scoring when confronted with these cases.
Conclusion
Imaging and reporting of spinal tumors can be a daunting task for any radiologist. An understanding of the potential pathologies at each location, as well as utilization of standard reporting templates for ESCC and SINS scoring, can make these challenging cases easier to interpret with valuable information for the referring clinician.
