Peripheral neuropathies encompass a broad spectrum of disorders, such as traumatic, compressive, inflammatory, metabolic, and neoplastic, that collectively affect millions of individuals in the United States. Their clinical presentations often overlap leading to diagnostic challenges. While electrodiagnostic studies help differentiate axonal from demyelinating processes and aid in assessing muscle reinnervation, they provide limited information regarding lesion localization, extent, and spatial distribution. MRI and ultrasonography offer complementary structural assessment, though US is constrained by lower sensitivity for deep nerves, operator dependence, and challenges in detecting subtle fascicular or muscle changes. Magnetic Resonance Neurography (MRN) has emerged as a transformative, non-invasive imaging technique that enables high-resolution visualization of peripheral nerves, plexuses, and associated pathologies. Leveraging advanced hardware, superior fat and vascular signal suppression, 3D isotropic acquisitions, and nerve-selective sequences, MRN overcomes the limitations of conventional MRI and allows detailed evaluation of fascicular architecture and denervation patterns. This first article in a two-part series reviews the technical foundations of MRN, including hardware considerations, sequence selection, and optimization strategies essential for high-quality nerve imaging. It also introduces NS-RADS, a standardized reporting and scoring system designed to enhance consistency and diagnostic confidence. The companion article focuses on clinical applications, characteristic and key imaging features, and pathognomonic MRN signs across common and uncommon neuropathies.

To examine the impact of artificial intelligence (AI) on radiologists’ workload and economic outcomes by synthesizing current evidence on workflow efficiency, burnout, and compensation dynamics. This narrative review synthesized peer-reviewed original studies, systematic reviews, and meta-analyses identified through a structured literature search of PubMed, focusing on clinical efficiency, occupational stress, economic value, and policy readiness across diagnostic, administrative, and informatics interventions. AI technologies have demonstrated benefits in triaging normal examinations, reducing turnaround times, and automating administrative tasks; for example, a single-center prospective intervention integrating a templated EHR–PACS interface reduced average report turnaround time from 11.2 to 6.9 min (a 38

Abstract Background: Adhesive capsulitis (AC) is defined as the gradual, progressive loss of range of joint motion due to inflammation, adhesions, and capsular thickening. Shoulder AC is well established with a prevalence of 2-5% in the general population, but the prevalence of hip AC remains unknown, likely due to underdiagnosis. Existing literature suggests shared risk factors between shoulder and hip AC—including diabetes, thyroid disease, trauma, and surgery. In addition, while AC has been studied in the general population, its prevalence has not been extensively evaluated in the oncologic population. Oncologic patients with hip pain frequently undergo contrast-enhanced MRI to exclude metastasis, yet the relative frequency of tumor infiltration versus adhesive capsulitis remains unclear. Prior (few) studies have only used non-contrast, fat-suppressed T2W MRIs, making it challenging to differentiate the capsule from the iliofemoral ligament clearly. CEMR incorporates non-contrast sequences, allowing assessment of key AC features—including capsular and iliofemoral ligament thickening or enhancement, as well as preferential fluid pooling in the posterior recess or iliopsoas bursa. Purpose: To determine the frequency of AC in patients with known primary malignancy undergoing CEMR of hip joint at a tertiary care academic center. Methods: In this cross-sectional retrospective analysis, from 01/2021 to 01/2025, CEMR studies of hip joints were identified, yielding 57 eligible examinations. Adult patients (>18) with a known primary malignancy were included. Exclusions comprised non-contrast MRIs, absence of confirmed malignancy, significant artifacts, recent trauma, or known inflammatory or infectious conditions. Prospectively, reports were generated by fellowship-trained MSK radiologists in our center. Studies were subsequently re-reviewed by an additional radiologist to evaluate for features of AC, including capsular thickening, capsular enhancement, fluid pooling in synovial recesses, and/or presence of tumor lesions in the imaged hips. Results: Preliminary analysis yields AC in 9/57(16%) cases. 48/57 (84%) MRIs demonstrated a malignant lesion, non-AC condition. Further analyses will assess how often hip adhesive capsulitis occurs across age groups, genders, and malignancy types. Quantitative measures of capsular thickening, enhancement, and joint recess distention will help refine characterization of these imaging findings. Conclusion: Though occurring at a smaller frequency, AC can present as hip pain in patients with known primary malignancy. Recognizing this pattern can help clinicians direct appropriate management and prevent unnecessary concern for metastatic disease. Citation Format: Laasya Madana, Avneesh Chhabra, Alireza Eajazi. Adhesive capsulitis vs. metastasis: Comparative frequency in oncology patients with hip pain [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 6308.

Soft-tissue tumors and tumorlike lesions are commonly identified on imaging and encompass a wide spectrum of entities. For lesions lacking classic features of a particular benign diagnosis, the radiologist must carefully assess its likelihood of representing an aggressive or malignant entity. However, in the absence of classic features, this determination is challenging. In 2023, the American College of Radiology (ACR) launched the development of Soft Tissue-RADS to serve as a unified framework for approaching these lesions. Soft Tissue-RADS, currently designated by the ACR as a work in progress, provides a standardized classification for soft-tissue tumors and tumorlike lesions encountered on MRI, incorporating seven categories (0 through 6), each with linked management recommendations, and diagnostic algorithms presented as flowcharts for guiding category selection. This Clinical Perspective provides an overview of Soft Tissue-RADS. We present the proposed risk categories and associated diagnostic algorithms, provide a structured report template, and show numerous case examples. The proposed system seeks to assist radiologists in differentiating benign soft-tissue tumors and tumorlike lesions from aggressive or malignant tumors, improve the clarity of radiology reports through succinct communication of malignancy risk, guide appropriate management recommendations, facilitate assessment of radiologic-pathologic concordance, refine posttreatment evaluation, and streamline data-informed approaches to sarcoma care.

Accurate interpretation of peripheral neuropathies on magnetic resonance neurography (MRN) requires not only high-quality imaging but also a structured, reproducible approach to evaluating nerve and muscle abnormalities. Building on the technical foundations outlined in Part 1, this second article of a two-part series focuses on the Neuropathy Score Reporting and Data System (NS-RADS) and its practical application in clinical interpretation. NS-RADS provides a standardized MRI-based framework for classifying diffuse neuropathy, entrapment, injury, neoplastic processes, and post-intervention changes, enabling consistent communication and improved diagnostic confidence. This review integrates the NS-RADS categories with the hallmark MRN signs that characterize the most common etiologies of peripheral neuropathy, including traumatic, compressive, inflammatory, and neoplastic disorders. Key imaging patterns—such as the target, spaghetti, honeycomb, garland, hourglass, Mount Fuji, meandering, zigzag, and triple-B signs—are illustrated and contextualized to highlight their diagnostic value and limitations. By combining a structured reporting system with pattern-based interpretation, this article aims to equip radiologists with a practical, efficient framework for evaluating peripheral nerve lesions and differentiating among overlapping neuropathic entities in routine clinical practice.

A standardized guideline and scoring system are recommended for the imaging evaluation of musculoskeletal infections on MR imaging. The Musculoskeletal Infection Reporting and Data System (MSKI-RADS) is a recently developed and validated classification system using MR imaging that can be used to classify the severity and extent of musculoskeletal infections, improve radiology-pathology concordance, and outline the corresponding management recommendations. This review article explains MSKI-RADS and discusses the different elements of this system in detail with a review of pertinent literature so that the readers can apply it in their practices. The work outlines the technical considerations for optimal MR imaging for evaluating various musculoskeletal infectious lesions, details the severity scales with examples of various conditions that fall under each class, and outlines related patient management recommendations. The readers can learn about the MSKI-RADS classification system and apply the gained information from this article to improve MRI interpretations in their practice and increase the effectiveness of their multidisciplinary communications. This standardized system will also allow longitudinal data collection and tracking for future research purposes. MSKI-RADS is a recently developed and validated MRI-based guideline for musculoskeletal infections in extremities. A comprehensive understanding of these classifications can facilitate improved standardized diagnostic reporting of musculoskeletal infections on MRI and better patient outcomes.

Objective Two-point Dixon MRI is widely used for lumbar plexus imaging but often yields incomplete fat suppression due to neglecting fat's multi-peak spectrum. This study developed and evaluated a post-processing algorithm that accounts for the multi-peak fat spectrum to achieve more effective fat suppression. Methods A novel Dark-fat processing algorithm was developed to enhance fat suppression in water-only MR images from standard two-point Dixon reconstruction. It was evaluated using a custom fat/water phantom, prospectively in a healthy volunteer, and retrospectively in 30 patients who underwent clinical lumbar plexus imaging between March and October 2023. Imaging was done using FFE (or GRE)-Dixon, TSE (or FSE)-Dixon, and mDixon-Quant. Quantitative metrics (SNR, apparent SNR (aSNR), and apparent CNR (aCNR)) and qualitative assessments by two radiologists were analyzed. Statistical significance was determined using Welch's t-test (p < 0.05) and Wilcoxon signed-rank test with Benjamini-Krieger-Yekutieli correction (q < 0.05). Results The Dark-fat processing (i) substantially decreased fat signal in water-only images (84% reduction) in phantom from two-point TSE-Dixon and was statistically not different from the reference standard, multi-echo mDixon-Quant (p = 0.58); (ii) improved overall fat suppression (q < 0.05, effect size = 0.67 and 0.92), while there was no significant difference in the anatomical visualization; (iii) significantly reduced aSNR in the subcutaneous fat (p < 0.0001, effect size > 1) and muscle (p < 0.01, effect size = 0.81); and (iv) did not alter aCNR between nerve and muscle tissue (p = 0.27, effect size = 0.29). Conclusion Dark-fat processing enables efficient and complete fat suppression in two-point Dixon acquisitions, especially TSE-Dixon, significantly enhancing lumbar plexus image quality. When implemented offline and as a retrospective method, it requires no change to scan time and can be applied to any two-point Dixon dataset.

Background -Hallux valgus (HV) is recognized as a triplanar foot deformity with optimal surgical results achieved when all three planes are addressed. We have previously reported on an ongoing 5-year, prospective, multicenter, clinical study using instrumented correction of the first tarsometatarsal joint (1st TMT) in patients with HV. Purpose -This report details interim 48-month results of this study, evaluating the impact of early postoperative tibial sesamoid position (TSP) on radiographic recurrence (postoperative hallux valgus angle (HVA) measurements of >15°), and whether radiographic recurrence impacted patient-reported outcomes. Study Design - One hundred seventy-three patients were included in this multicenter study, of whom 146 patients achieved their 48-month visit. Radiographic parameters were presented at baseline, 6 weeks and 48 months. This included intermetatarsal angle (IMA) along with TSP and HVA. Methods - Institutional review board approval was obtained for each study site. A consecutive cohort of patients were enrolled from November 2018 to April 2021 who received 1st TMT arthrodesis to correct their hallux valgus deformity. Inclusion and exclusion criteria were established. Results - At the 48-month follow-up, 12 patients (8.2%) had radiographic recurrence with an HVA>15°. Evaluation of TSP position at 6-weeks postoperative found that a TSP≤ 3 reduced the likelihood of recurrence by 95% compared to a TSP>3. Conclusion - The results of this interim analysis suggest that initial correction of axial rotation and sesamoid position of the first ray is important in maintaining correction long term and favorable patient reported outcomes.

Background . Plantar fibroma (PF) is a benign growth on the plantar aponeurosis potentially causing pain, swelling, and sensory changes. This study seeks to determine demographic differences in PF’s MRI presentation and treatments. Methods . This retrospective cross-sectional study included cases of MRI-confirmed PF interpreted by fellowship-trained MSK radiologists. Demographics, symptoms, MR-findings, and treatments provided were studied. Treatments were correlated with symptoms and demographics. All symptoms were weighted equally, and analysis of the number of cumulative symptoms was performed. Fisher’s exact test, Chi Square test, and Kruskal-Walis rank sum test were performed. Results . Among 196 PF in 177 patients, male:female ratio was 53:47. The race distribution was Indigenous 2%, Asian 2%, Black 30%, White 61%, and Unknown 5%. Hispanic:Non-Hispanic ratio was 28:69. The cumulative symptoms for patients receiving physical therapy (n = 8), steroid injections (n = 26), surgery (n = 26), and pain medications (n = 126) were 1.38, 1.15, 1.05, and 0.5, respectively. Hispanic patients had multiple cords involved (p = 0.023) and more homogenous MR-signal (p < 0.001). Female patients are more likely to exhibit hyperintense PFs on fluid-sensitive sequences (p = 0.037) and receive aggressive treatments (p < 0.001). Male patients had larger PFs (p = 0.03). Black patients had the largest and Indigenous patients had the smallest PFs (p = 0.001). Patients with more symptoms, and symptoms of pain received focused treatments (p < 0.001). Black patients were more likely to receive surgery, and White patients were more likely to receive pain medication alone (p = 0.025). Conclusion . In this epidemiological study of a large database of MRI-confirmed PF, several demographic factors varied for patients’ MRI presentations and treatments.

Objectives To assess peroneal compartment pathology frequency in patients with 3-T ankle MRIs for ankle pain/injury and correlate with clinical findings. Method 373 patients with suspected internal ankle derangements who underwent 3-T ankle MRIs were included. The scans were independently reviewed by two blinded musculoskeletal radiologists, who classified cases as normal or exhibiting peroneal pathologies, including peroneus longus and brevis tenosynovitis, tendinopathy, tears, superior peroneal retinaculum injuries, and anatomical variants, based on established literature criteria. Agreement was assessed using Cohen's kappa, and pathologies were correlated with acute-versus-chronic pain and the presence/absence of laterality of pain. Results 404 ankle MRIs from 373 patients (mean age, 49 years ± 12, 112 male) were evaluated. The overall frequency of peroneal tendon pathology was 71.0%, 34.4% common peroneal tenosynovitis, 12.6% peroneus brevis tenosynovitis, and 14.1% peroneus longus tenosynovitis. Peroneus brevis tendinopathy appeared in 22.5% of cases, with 23.5% partial/split tears and 0.5% complete tears. Peroneus longus tendinopathy appeared in 37.6% of cases, with 2.0% partial/split tears and 0.2% complete tears. Peroneus quartus was seen in 31.7% of cases, 4.0% had a low peroneus brevis muscle belly, and 40.1% had a thickened superior peroneal retinaculum. Conclusion Peroneal pathology is common on 3-T ankle MRIs. Chronic ankle pain correlates with tendinopathy, and lateral pain with tenosynovitis. Radiologists should note this high prevalence even without lateral pain, and assess retinaculum thickness to improve diagnostic confidence given correlation with tendon and tenosynovial abnormalities.

Soft tissue-RADS scoring system for musculoskeletal (MSK) tumor and tumor-like lesions is recently published. The system includes diagnostic MRI flowcharts and algorithms for lipomatous masses, cyst-like or high-water content masses, and indeterminate-solid appearing masses with consistent and standardized management recommendations. MSK radiology and cancer imaging training commonly provides the essential skills needed to render appropriate prospective diagnosis for many non-neoplastic tumor-like lesions and various commonly encountered sarcomas. Such trained readers may benefit from additional advanced algorithms to accurately identify and categorize different benign tumors and sarcomas and correctly input them in the soft tissue-RADS scoring system. These algorithms are built from a comprehensive literature search to establish an evidence-based composite and are supported by the expert opinions of the multidisciplinary ACR-soft tissue-RADS team. In this article we provide (1) a literature review of multimodality imaging, immunopathology, and clinical findings of soft tissue tumors and tumor-like lesions, presented in 7 tables (condensed from the 12 tables published in the WHO classification of soft tissue tumors) with respective table summaries; (2) a suggested modality-based lexicon; and (3) advanced diagnostic algorithms for trained readers based on published evidence and expert opinion that feed into the soft tissue-RADS scoring system (categories 1–6). The purpose of this work is to provide comprehensive guidance on soft tissue-RADS scoring to help streamline care for soft tissue tumors and tumor-like lesions and optimize patient outcomes.

Diffusion-weighted magnetic resonance imaging (DWI) analyzes water diffusion in tissues, indirectly reflecting cellular density and aiding tumor characterization. Our objective was to explore the utility of DWI in three topics: (i) differentiation of bone and soft tissue sarcomas with respect to tumor type/grade; (ii) correlation with chemotherapy response in Ewing's sarcoma and osteosarcoma; and (iii) differentiation of benign from malignant soft tissue and bone tumors. The aim of the review article was to assess the existing literature detailing the insight that can be provided by DWI when addressing bone and soft tissue tumors. A search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using Pubmed, Scopus, Embase, and CENTRAL databases from 1 January 2013 to 30 November 2023. Eligible studies were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) scoring system. In total, 22 studies met the inclusion criteria. DWI proved effective in select scenarios when distinguishing among bone and soft tissue sarcomas (sensitivity = 48%-89%, specificity = 75%-100%), correlating chemotherapy response with histopathology results (sensitivity = 25%-85%, specificity = 50%-100%), and differentiating between benign and malignant bone tumors (sensitivity = 54%-92%, specificity = 39%-92%) and soft tissue tumors (sensitivity = 68%-91%, specificity = 60%-81%). DWI is a valuable tool for the diagnosis and prognosis of bone and soft tissue sarcomas, treatment effect of primary bone tumors, and distinguishing benign from malignant bone/soft tissue tumors. Though promising, the technology has shown mixed results, warranting further research.

This study assesses whether an association exists between radiographic measurements of progressive collapsing foot deformity and MRI assessment of posterior tibial tendon (PTT) dysfunction. After institutional approval, a retrospective search was conducted for patients who presented between 2017 and 2023 with foot and ankle pain and for whom 3D ankle MRIs and weight-bearing ankle radiographs were performed within 3 months of each other. One hundred fifty-seven feet that met the criteria were identified. The talonavicular uncoverage angle (TU), Meary’s angle, calcaneal pitch, cuneiform-fifth metatarsal height (C-5MT), and Djian–Annonier’s angle (DA) were calculated on weight-bearing ankle radiographs. MRI was used to assess the PTT, spring ligament (SL), and superficial and deep deltoid ligament (DL). Associations between radiographic measurements and MRI findings were explored through pairwise Wilcoxon rank-sum tests with Holm’s adjustment. Secondary analysis included multivariable regression for covariate adjustment and reader agreement. Patients with complete PTT tears exhibited a statistically significantly increased TU (38.5 ± 9.2), decreased Meary’s angle (−26.7 ± 9.1) and decreased C-5MT (−3.9 ± 5.7) than patients with partial tear (TU 16.3 ± 9.9; Meary’s angle −5.6 ± 8.7; C-5MT 10.5 ± 5.0) and without tear (TU 115.8 ± 10.7; Meary’s angle −5.6 ± 7.7; C-5MT 9.5 ± 6.6). Meary’s angle and C-5MT were statistically different in the superficial DL groups complete tear versus partial tear and non-tear (Meary’s angle −26.1 ± 15.4 versus −8.0 ± 8.5 and −5.6 ± 8.2, respectively, both p < 0.001; C-5MT −2.9 ± 8.3 versus 9.8 ± 6.3, p = 0.007, and 8.7 ± 7.0, p = 0.002, respectively). DA was associated with superficial deltoid ligament complete tear versus non-tear (DA 144.9 ± 14.4 versus 127.1 ± 11.8, p = 0.037). Although not statistically significant, a considerable difference in mean values of TU was found between SL complete tear and partial tear and non-tear with marginal p values (TU 2.6 ± 7.9 versus 18.6 ± 14.4, p = 0.051, and 16.6 ± 10.4, p = 0.056, respectively). None of the radiographic measurements were associated with deep DL status or PTT tenosynovitis. Forefoot abduction measured by TU, as well as medial longitudinal arch collapse measured by Meary’s angle and C-5MT, is associated with PTT complete tear versus non-tear or partial tear. Meary’s angle, DA, and C-5MT also demonstrated implications for superficial DL status. Additional research with larger sample sizes will be helpful to clarify the statistical tendency of association between SL and TU.

Hip dysplasia (HD) is a known risk factor for early morbidity in the young adult hip. HD causes a variety of pathologic changes to the hip through an asymmetrical distribution of forces. Periacetabular osteotomy (PAO) is becoming increasingly recognized as a treatment. Labral tears occur frequently in the setting of HD and there still remain questions regarding the best treatment practices for labral pathology. We sought to determine whether intraoperative labral tear size was associated with short-term patient-reported outcomes following concomitant hip arthroscopy and PAO. Seventy-one hips that underwent PAO with concomitant hip arthroscopy at our tertiary care hip center from February 2017 to June 2021 who had PROM follow-up time of more than one year were investigated (88.7

To synthesize magnetic resonance imaging (MRI) features and their reported diagnostic performance that differentiate benign from malignant soft-tissue tumors in alignment with the 2020 World Health Organization classification. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials were searched through July 2024. Eligible studies reported MRI feature frequencies or diagnostic accuracy for common soft-tissue tumor subtypes. Reviews, case reports, duplicates, non-English publications, and studies outside the scope were excluded. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Seventy-six studies met inclusion criteria. In lipomatous tumors, homogeneous fat signal and thin septa supported lipoma, whereas thick or nodular septa and enhancement favored atypical or well-differentiated liposarcoma. Myxofibrosarcoma often demonstrated an infiltrative fascial “tail.” Vascular lesions included angioleiomyoma with a reticular T2 pattern and glomus tumor with marked T2 hyperintensity and avid enhancement. In peripheral nerve sheath tumors, lower apparent diffusion coefficient values and peritumoral edema favored malignancy. Heterogeneity in imaging protocols precluded meta-analysis; results were summarized descriptively by subtype. Consolidated MRI patterns—such as septal morphology in lipomatous tumors, the fascial tail in myxofibrosarcoma, characteristic T2 patterns in vascular lesions, and diffusion and edema cues in nerve sheath tumors—support differentiation of benign and malignant entities, enhance reader confidence, and inform biopsy and management. Standardized prospective studies are needed to validate these thresholds and improve generalizability.

OBJECTIVES:To determine the frequency, laterality, diameter, and arterial origin of the corona mortis (CM) using computed tomography angiography (CTA) in a large consecutive cohort from two affiliated academic hospitals. A secondary objective was to assess demographic associations with CM, including age, sex, body mass index (BMI), and race or ethnicity. METHODS:This retrospective study evaluated 988 consecutive abdominal and pelvic CTAs performed between 2020 and 2022 at Parkland Hospital and Clements University Hospital, representing 1976 hemipelvises. All patients aged be ≥ 18 years with diagnostic-quality CTA were included. Studies were not excluded for trauma indications or prior pelvic surgery, ensuring an inclusive, real-world imaging population. CM presence, laterality, vessel diameter, and arterial origin were recorded. Demographic variables were collected, and analyses were performed using the Wilcoxon rank-sum test, paired t-test, and sign test. RESULTS:Arterial CM was identified in 318 of 988 patients (32.2%). Among CM-positive cases, 53% were unilateral and 47% bilateral, with laterality distributed as 25% right-sided, 27% left-sided, and 47% bilateral. The median vessel diameter measured 2.40 mm (IQR, 2.00-2.50 mm). Most CMs originated from the inferior epigastric artery (98%), while 2.3% arose directly from the external iliac artery. CM was more common in females and in non-Hispanic Black individuals. Patients with CM were significantly older than those without (p = 0.035). Vessel diameter differed significantly between sexes (paired t-test, p = 0.004; sign test, p = 0.006). CONCLUSIONS:Across two major academic hospitals, this large consecutive CTA cohort-the largest reported to date-identified arterial CM in nearly one-third of patients and demonstrated meaningful demographic variability. Given its potential for clinically significant bleeding, systematic evaluation of CM on preoperative or preprocedural CTA may help reduce iatrogenic vascular injury during pelvic and acetabular surgery.

AIM:When radiologists encounter an unfamiliar musculoskeletal neoplasm on conventional and advanced MR images, they now have an option to search the internet for MRI image examples. The purpose of this project was to systematically evaluate the quality of images returned by a widely used general search engine. MATERIALS AND METHODS:Systematic internet searches were conducted for 16 benign and malignant musculoskeletal neoplasms, focusing on T1-weighted (T1W), T2-weighted (T2W), contrast-enhanced, diffusion-weighted (DWI), and out-of-phase MR images. The top five images from each search were evaluated for image quality and clinical relevance using a 5-point scoring key. RESULTS:General internet engine returned correct sequence among the top five results for 88% of lesions when searched for T1W images, 100% for T2W images, 100% for contrast-enhanced images, 63% for DWI, and 25% for out-of-phase images. Fleiss Kappa statistic demonstrated substantial agreement (Kappa = 0.72) for binary "useful" vs "not useful" image designation, and moderate agreement (Kappa = 0.48) for all five categories. CONCLUSION:The general internet search engine returned useful results when searching for conventional MRI sequences but performed sub-optimally when searching for advanced MR image examples.

This review aims to assess the diagnostic performance of MRI in distinguishing benign from malignant soft tissue tumors and evaluate conventional MRI sequences (Aim 1), as well as assess diffusion-weighted imaging (DWI) for tumor differentiation (Aim 2A) and tumor grading (Aim 2B). PubMed, Scopus, Embase, and CENTRAL were searched from inception to March 2025 using keywords like “MRI,” “soft tissue sarcoma,” “sensitivity,” “specificity,” and “diffusion.” Studies with ≥ 20 cases reporting sensitivity and specificity for MRI or DWI were included for Aims 1/2A; studies on DWI for grading were included for Aim 2B. Four reviewers screened titles, abstracts, and full texts, resolving disagreements by consensus. A total of 224 studies were initially identified, and 34 were included for final analysis (Aim 1: 16, Aim 2A: 12, Aim 2B: 6). Conventional MRI (Aim 1) demonstrated sensitivities of 61–100