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CC BY 4.0 · Indian J Med Paediatr Oncol 2023; 44(02): 261-267
DOI: 10.1055/s-0042-1760404
Review Article

Imaging Recommendations for Diagnosis, Staging, and Management of Soft Tissue Sarcomas

Kenneth Lupton
1   Leeds Teaching Hospitals, Leeds, United Kingdom
,
Manjusha Salins
2   Department of Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom
,
Bill Pass 
3   Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom
,
Raj Negi
4   Department of Radiology and Imaging, University Hospital Lewisham, London, United Kingdom
,
Harun Gupta
1   Leeds Teaching Hospitals, Leeds, United Kingdom
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Abstract

Soft tissue lesions are a wide range of tumors of mesenchymal cell origin, occurring anywhere in the body with a vast number of histological subtypes both benign and malignant. These are common in clinical practice and vast majority are benign. This article focuses on soft tissue sarcoma of the trunk and extremities and discusses their imaging guidelines.

Keywords

human gammaherpesvirus 8 - human immunodeficiency virus - MFS - soft tissue sarcoma


Publication History

Article published online:
01 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Dangoor A, Seddon B, Gerrand C, Grimer R, Whelan J, Judson I. UK guidelines for the management of soft tissue sarcomas. Clin Sarcoma Res 2016; 6 (01) 20
    CrossrefPubMedGoogle Scholar
  • 2 Bansal A, Goyal S, Goyal A, Jana M. WHO classification of soft tissue tumours 2020: An update and simplified approach for radiologists. Eur J Radiol 2021; 143: 109937 DOI: 10.1016/j.ejrad.2021.109937.
    CrossrefPubMedGoogle Scholar
  • 3 van Vliet M, Kliffen M, Krestin GP, van Dijke CF. Soft tissue sarcomas at a glance: clinical, histological, and MR imaging features of malignant extremity soft tissue tumors. Eur Radiol 2009; 19 (06) 1499-1511
    CrossrefPubMedGoogle Scholar
  • 4 von Mehren M, Kane JM, Agulnik M. et al. NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines ®). Soft Tissue Sarcoma. Version 2.2022 - 17/05/2022. NCCN.org. Accessed 23/05/2022. https://www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf
  • 5 PDQ Adult Treatment Editorial Board. PDQ Soft Tissue Sarcoma Treatment. Bethesda MD. National Cancer Institute. Updated 19/01/2022. Accessed December 23, 2022, at: http://www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq
    Google Scholar
  • 6 Ilaslan H, Schils J, Nageotte W, Lietman SA, Sundaram M. Clinical presentation and imaging of bone and soft-tissue sarcomas. Cleve Clin J Med 2010; 77 (1, Suppl 1): S2-S7
    CrossrefPubMedGoogle Scholar
  • 7 NICE has updated NICE Guideline 12, Suspected cancer: recognition and referral. Guidelines in Practice [Internet]. 2020 Oct [cited 2022 Jun 6];23(10):8. Accessed December 23, 2022, at:: https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=edo&AN=146957423&site=eds-live
    Google Scholar
  • 8 Gronchi A, Miah AB, Dei Tos AP. et al; ESMO Guidelines Committee, EURACAN and GENTURIS. Electronic address: clinicalguidelines@esmo.org. Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up☆ . Ann Oncol 2021; 32 (11) 1348-1365
    CrossrefPubMedGoogle Scholar
  • 9 Kransdorf MJ, Murphey MD, Wessell DE. et al; Expert Panel on Musculoskeletal Imaging. ACR Appropriateness Criteria® Soft-Tissue Masses. J Am Coll Radiol 2018; 15 (5S): S189-S197
    CrossrefPubMedGoogle Scholar
  • 10 Bradley M, Robinson P, Gerrand C, Hayes A. et al. Ultrasound screening of soft tissue masses in the trunk and extremity. A British sarcoma group guide for ultrasonographers and primary care. British Sarcoma Group. January 2019. Accessed Dec 2022. https://britishsarcomagroup.org.uk/news/ultrasound-screening-of-soft-tissue-masses-in-the-trunk-and-extremity/
    Google Scholar
  • 11 Noebauer-Huhmann IM, Weber MA, Lalam RK. et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol 2015; 19 (05) 475-482
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 American Cancer Society. Soft Tissue Sarcoma Early Detection, Diagnosis, and Staging [Internet]. Revised 06/04/2018. Cited 06/06/2022. Accessed December 23, 2022, at: https://www.cancer.org/cancer/soft-tissue-sarcoma/detection-diagnosis-staging/detection.html
    Google Scholar
  • 13 Scalas G, Parmeggiani A, Martella C. et al. Magnetic resonance imaging of soft tissue sarcoma: features related to prognosis. Eur J Orthop Surg Traumatol 2021; 31 (08) 1567-1575
    CrossrefPubMedGoogle Scholar
  • 14 Aga P, Singh R, Parihar A, Parashari U. Imaging spectrum in soft tissue sarcomas. Indian J Surg Oncol 2011; 2 (04) 271-279
    CrossrefPubMedGoogle Scholar
  • 15 Gartner L, Pearce CJ, Saifuddin A. The role of the plain radiograph in the characterisation of soft tissue tumours. Skeletal Radiol 2009; 38 (06) 549-558 cited 2022Jun6 [Internet]
    CrossrefPubMedGoogle Scholar
  • 16 Rowbotham E, Bhuva S, Gupta H, Robinson P. Assessment of referrals into the soft tissue sarcoma service: evaluation of imaging early in the pathway process. Sarcoma 2012; 2012: 781723
    CrossrefPubMedGoogle Scholar
  • 17 Lakkaraju A, Sinha R, Garikipati R, Edward S, Robinson P. Ultrasound for initial evaluation and triage of clinically suspicious soft-tissue masses. Clin Radiol 2009; 64 (06) 615-621
    CrossrefPubMedGoogle Scholar
  • 18 Singer AD, Wong P, Umpierrez M. et al. The accuracy of a novel sonographic scanning and reporting protocol to survey for soft tissue sarcoma local recurrence. Skeletal Radiol 2020; 49 (12) 2039-2049
    CrossrefPubMedGoogle Scholar
  • 19 Crombé A, Marcellin PJ, Buy X. et al. Soft-tissue sarcomas: assessment of MRI features correlating with histologic grade and patient outcome. Radiology 2019; 291 (03) 710-721
    CrossrefPubMedGoogle Scholar
  • 20 Spinnato P, Clinca R, Vara G. et al. MRI features as prognostic factors in myxofibrosarcoma: proposal of MRI grading system. Acad Radiol 2021; 28 (11) 1524-1529
    CrossrefPubMedGoogle Scholar
  • 21 Yoo HJ, Hong SH, Kang Y. et al. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value. Eur Radiol 2014; 24 (08) 1749-1757
    CrossrefPubMedGoogle Scholar
  • 22 Sambri A, Spinnato P, Bazzocchi A, Tuzzato GM, Donati D, Bianchi G. Does pre-operative MRI predict the risk of local recurrence in primary myxofibrosarcoma of the extremities?. Asia Pac J Clin Oncol 2019; 15 (05) e181-e186
    CrossrefPubMedGoogle Scholar
  • 23 Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N. Synovial sarcoma of the soft tissues: prognostic significance of imaging features. J Comput Assist Tomogr 2004; 28 (01) 140-148
    CrossrefPubMedGoogle Scholar
  • 24 Gimber LH, Montgomery EA, Morris CD, Krupinski EA, Fayad LM. MRI characteristics associated with high-grade myxoid liposarcoma. Clin Radiol 2017; 72 (07) 613.e1-613.e6
    CrossrefPubMedGoogle Scholar
  • 25 Panicek DM, Gatsonis C, Rosenthal DI. et al. CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: report of the Radiology Diagnostic Oncology Group. Radiology 1997; 202 (01) 237-246
    CrossrefPubMedGoogle Scholar
  • 26 Sambri A, Bianchi G, Longhi A. et al. The role of 18F-FDG PET/CT in soft tissue sarcoma. Nucl Med Commun 2019; 40 (06) 626-631
    CrossrefPubMedGoogle Scholar
  • 27 Bischoff M, Bischoff G, Buck A. et al. Integrated FDG-PET-CT: its role in the assessment of bone and soft tissue tumors. Arch Orthop Trauma Surg 2010; 130 (07) 819-827
    CrossrefPubMedGoogle Scholar
  • 28 Shin DS, Shon OJ, Han DS, Choi JH, Chun KA, Cho IH. The clinical efficacy of (18)F-FDG-PET/CT in benign and malignant musculoskeletal tumors. Ann Nucl Med 2008; 22 (07) 603-609
    CrossrefPubMedGoogle Scholar
  • 29 Lee L, Kazmer A, Colman MW, Gitelis S, Batus M, Blank AT. What is the clinical impact of staging and surveillance PET-CT scan findings in patients with bone and soft tissue sarcoma?. J Surg Oncol 2022; 125 (05) 901-906
    CrossrefPubMedGoogle Scholar
  • 30 Kassem TW, Abdelaziz O, Emad-Eldin S. Diagnostic value of 18F-FDG-PET/CT for the follow-up and restaging of soft tissue sarcomas in adults. Diagn Interv Imaging 2017; 98 (10) 693-698
    CrossrefPubMedGoogle Scholar
  • 31 Seeger LL. Revisiting Tract Seeding and Compartmental Anatomy for Percutaneous Image-Guided Musculoskeletal Biopsies. Vol. 48, Skeletal Radiology. Springer Verlag; 2019: 499-501
    Google Scholar
  • 32 Veltri A, Bargellini I, Giorgi L, Almeida PAMS, Akhan O. CIRSE guidelines on percutaneous needle biopsy (PNB). Cardiovasc Intervent Radiol 2017; 40 (10) 1501-1513
    CrossrefPubMedGoogle Scholar
  • 33 Cates JMM. The AJCC 8th edition staging system for soft tissue sarcoma of the extremities or trunk: a cohort study of the SEER database. J Natl Compr Canc Netw 2018; 16 (02) 144-152 cited 2022Jun7 [Internet]
    CrossrefPubMedGoogle Scholar
  • 34 Rothermundt C, Whelan JS, Dileo P. et al. What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients. Br J Cancer 2014; 110 (10) 2420-2426
    CrossrefPubMedGoogle Scholar
  • 35 Hovgaard TB, Nymark T, Skov O, Petersen MM. Follow-up after initial surgical treatment of soft tissue sarcomas in the extremities and trunk wall. Acta Oncol 2017; 56 (07) 1004-1012
    CrossrefPubMedGoogle Scholar
  • 36 Park JW, Yoo HJ, Kim HS. et al. MRI surveillance for local recurrence in extremity soft tissue sarcoma. Eur J Surg Oncol 2019; 45 (02) 268-274
    CrossrefPubMedGoogle Scholar
  • 37 Puri A, Gulia A, Hawaldar R, Ranganathan P, Badwe RA. Does intensity of surveillance affect survival after surgery for sarcomas? Results of a randomized noninferiority trial. Clin Orthop Relat Res 2014; 472 (05) 1568-1575
    CrossrefPubMedGoogle Scholar