The diagnosis of spinal tumors: established and emerging methods.

Introduction: Spinal tumors comprise a biologically heterogeneous group of neoplasms associated with different treatment strategies and varying prognoses. The accurate diagnosis of these tumors is, therefore, imperative to direct appropriate patient care. Here, the authors review established and emerging tools in the fields of diagnostic imaging and pathology for the assessment of spinal tumors.

Areas covered: An approach to standard diagnostic imaging modalities such as plain radiographs, computed tomography, magnetic resonance imaging and angiography is discussed with emphasis on the application of emerging methods such as diffusion tensor imaging, and magnetic resonance spectroscopy to the diagnosis of spinal tumors. Tissue-based diagnostic approaches, including histology and immunohistochemistry, are also reviewed, with a discussion of future trends in the fields of genetics and molecular biology. The authors additionally summarize classical findings of common spinal tumors.

Expert opinion: With the appropriate clinical suspicion, numerous complementary tools are used to facilitate the diagnosis of spinal tumors. Increasing knowledge of tumor biology and better discrimination of tumor subtypes will continue to play a significant role in guiding patient-specific treatment decisions.