With the novel coronavirus disease (COVID-19) being declared a global pandemic by the World Health Organization, the Indian healthcare sector is at the forefront to deliver optimal care. Patients with cancer especially are at serious risk for increased chances of morbidity and mortality due to their immunocompromised state. Currently there is a paucity of definitive guidelines for the management of sarcomas during the pandemic in a resource-constrained and diverse population setting like India. Health care professionals from various specialties involved in the management of sarcomas have collaborated to discuss various aspects of evidence-based sarcoma management during the COVID-19 pandemic. This article provides structured recommendations for HCP to adapt to the situation, optimize treatment protocols with judicious use of all resources while providing evidence-based treatment for sarcoma patients.

Conventional MRI is limited in imaging tissues with short T2 relaxation times, such as bone, ligaments, and cartilage, due to their rapid signal decay. This limitation has spurred the development of specialized MRI techniques designed specifically for short‐T2 tissue imaging. Traditional pulse sequences, including three‐dimensional gradient echo (3D‐GRE), susceptibility‐weighted imaging (SWI), and Fast Field Echo Resembling a CT using Restricted Echo‐Spacing (FRACTURE), initially addressed some of these challenges but often lacked sufficient resolution or contrast differentiation. Recent advancements, such as ultrashort echo time (UTE), zero echo time (ZTE), 3D‐Bone, and synthetic computed tomography (sCT), have significantly enhanced the diagnostic capabilities of MRI by providing high‐quality, CT‐like visualization without exposure to ionizing radiation. These innovations have substantially improved MRI's ability to depict bone morphology, assess joint pathology, identify subtle fractures, and characterize bone tumors with higher accuracy. Beyond musculoskeletal applications, these techniques have demonstrated emerging clinical utility in additional domains, including pulmonary and dental imaging. This review article evaluates conventional pulse sequences alongside emerging MRI innovations, highlighting their clinical applications, current limitations, and technical considerations. Continued optimization of these techniques promises broader clinical adoption, potentially reducing dependence on invasive and radiation‐intensive imaging modalities.Evidence Level: N/ATechnical Efficacy: Stage 3

How to cite this article: Patra A, Janu A, Sahu A. MR Imaging in Neurocritical Care. Indian J Crit Care Med 2019;23(Suppl 2):S104–S114.

Purpose: To evaluate the multimodality imaging features of chondroblastoma. Materials and Methods: Retrospective analysis of imaging features of 52 cases of histopathologically proven chondroblastoma from 2010 to 2022 was performed. Radiographs were evaluated for lesion site, location, morphology, margins, matrix mineralization, cortical breach, periosteal reaction, eccentricity, and subarticular extension. Appearance on T1, T2 weighted and post-contrast T1 was evaluated on MRI, with analysis of peritumoral edema and joint effusion. Results: Mean patient age was 18 years (10–57 years) with male preponderance (M = 39; F = 13). 75% (n = 39) cases involved an unfused skeleton and 25% (n = 13) affected a mature skeleton. Appendicular skeleton was involved in 88.5% (n = 46) cases and axial skeleton was involved in 11.5% (n = 6) cases with all cases involving epiphysis/epiphyseal equivalent. Radiographically, all cases were well-defined geographic osteolytic lesions with a narrow zone of transition, thin sclerotic rim and lobulated [56% (n = 29)] or smooth [44% (n = 23)] margins. Matrix calcification appreciable in 62% (n = 32) cases was ‘fluffy/smudgy’. Chondroblastoma appeared isointense (83%, n = 43) on T1 MRI with characteristically low signal and hyperintense foci within (67%, n = 35) on T2-weighted images and post-contrast enhancement [heterogeneous lobular (88%, n = 46) or septal pattern (12%, n = 6)] with all barring three lesions showing perilesional edema. None of the cases of chondroblastoma in our study developed metastasis till last follow-up (mean: 71 months). Conclusion: Chondroblastoma has distinctive imaging appearance and is often unlike majority other cartilaginous benign lesions due to characteristic low T2 signal on MRI and associated exuberant perilesional edema.