Background/Objectives: Intraneural tumors (INTs) pose a diagnostic challenge, owing to their varied origins within nerve fascicles and their wide spectrum, which includes both benign and malignant forms. Accurate diagnosis and management of these tumors depends upon the skills of the radiologist in identifying key imaging features and correlating them with the patient’s clinical symptoms and examination findings. Methods: This comprehensive review systematically analyzes the various imaging features in the diagnosis of intraneural tumors, ranging from basic MR to advanced MR imaging techniques such as MR neurography (MRN), diffusion tensor imaging (DTI), and dynamic contrast-enhanced (DCE) MRI. Results: The article emphasizes the differentiation of benign from malignant lesions using characteristic MRI features, such as the “target sign” and “split-fat sign” for tumor characterization. The role of advanced multiparametric MRI in improving biopsy planning, guiding surgical mapping, and enhancing post-treatment monitoring is also highlighted. The review also underlines the importance of common diagnostic pitfalls and highlights the need for a multi-disciplinary approach to achieve an accurate diagnosis, appropriate treatment strategy, and post-therapy surveillance planning. Conclusions: In this review, we illustrate the main imaging findings of intraneural tumors, focusing on specific MR imaging features that are crucial for an accurate diagnosis and the differentiation between benign and malignant lesions.
Primary malignant bone tumours can pose significant diagnostic and therapeutic challenges due to inter-tumour heterogeneity. While traditional imaging modalities such as radiography, MRI (magnetic resonance imaging), and CT (computed tomography) remain essential for initial evaluation and staging, emerging evidence underscores the evolving role of positron emission tomography (PET), particularly PET/CT with Fluorodeoxyglucose ([18F] FDG), in the comprehensive management of bone sarcomas. This narrative review aims to critically summarise the available literature on PET imaging’s utility in the management of primary bone tumours including osteosarcoma, chondrosarcoma, and Ewing sarcoma. Despite limitations like inconsistencies in standard uptake value (SUV) cutoffs and reduced pulmonary resolution, PET/CT is valuable for staging, assessing response to neoadjuvant chemotherapy, predicting histological outcomes, detecting recurrence, and guiding biopsy in metabolically active tumour sites. Further large-scale, prospective studies are warranted to standardise protocols and establish PET’s definitive role in sarcoma management.