The use of gadolinium in the MR evaluation of soft tissue tumors.

MRI has emerged as the preferred modality for the imaging evaluation of musculoskeletal tumors. Although there is general agreement on the value of MR in detection, diagnosis and staging, the use of intravenous contrast in the evaluation of soft-tissue tumors and tumor-like masses remains controversial. The purpose of this review is to highlight these controversies, to put them in perspective, and to make recommendations for the use of gadolinium-enhanced imaging. The following specific areas will be addressed: (1) general considerations in the evaluation of soft tissue tumors, (2) added specificity in diagnosis, (3) response to chemotherapy, (4) evaluation for local recurrence after surgery and/or radiation therapy, and (5) selection of biopsy site.