Limits...
Post-operative imaging of soft tissue sarcomas.

James SL, Davies AM - Cancer Imaging (2008)

Bottom Line: The aim of follow-up imaging with any malignancy is to detect recurrence promptly so that treatment can be instigated at the earliest possible opportunity.The role of radiographs, computed tomography, magnetic resonance imaging and positron emission tomography is reviewed followed by a discussion on the imaging modalities useful in the detection of metastatic disease.Finally, we present a robust pathway that is suggested for the follow-up of patients with an extremity soft tissue sarcoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK. steven.james@roh.nhs.uk

ABSTRACT
Soft tissue sarcomas are uncommon malignancies that have a high risk of local recurrence despite adequate initial surgery. The aim of follow-up imaging with any malignancy is to detect recurrence promptly so that treatment can be instigated at the earliest possible opportunity. In this review article, we discuss the imaging modalities that can be employed to detect local recurrence following surgery for an extremity soft tissue sarcoma. The role of radiographs, computed tomography, magnetic resonance imaging and positron emission tomography is reviewed followed by a discussion on the imaging modalities useful in the detection of metastatic disease. Finally, we present a robust pathway that is suggested for the follow-up of patients with an extremity soft tissue sarcoma.

Show MeSH

Related in: MedlinePlus

Post-radiotherapy change. Coronal STIR and axial T2-weighted fat suppressed images showing diffuse oedema affecting the medial aspect of the distal thigh corresponding exactly with the radiation field. Note that although there is a hyperintense signal it does not have true mass effect.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2267691&req=5

Figure 7: Post-radiotherapy change. Coronal STIR and axial T2-weighted fat suppressed images showing diffuse oedema affecting the medial aspect of the distal thigh corresponding exactly with the radiation field. Note that although there is a hyperintense signal it does not have true mass effect.

Mentions: Post-radiation reactive changes demonstrate a high signal on T2-weighted sequences but are not usually associated with a mass lesion (Figs. 2 and 7). The oedema may be demonstrated in the subcutaneous tissue or tracking along the normal myofibrillar planes with a typical feathery pattern (Fig. 7). When this is identified, comparison with the T1-weighted sequences should demonstrate the ‘muscle texture sign’ to still be present. There are wide variations in the length of time it takes for this soft tissue oedema to resolve, however, it usually peaks at between 6 and 18 months following treatment and persists for between 2 and 4 years. The oedema tends to persist for longer around the intramuscular septa than in the fat or muscle itself and is more prominent for patients treated with neutron radiation than photon radiation. STIR sequences will identify this imaging finding for longer periods that T2-weighted sequences. Following radiation therapy, the thickness of the subcutaneous fat increases whereas the muscle size tends to decrease27. Post-operative fibrosis typically demonstrates low signal intensity on both T1- and T2-weighted sequences (similar to muscle) and shows little or no enhancement with gadolinium (Fig. 8)28.Figure 7


Post-operative imaging of soft tissue sarcomas.

James SL, Davies AM - Cancer Imaging (2008)

Post-radiotherapy change. Coronal STIR and axial T2-weighted fat suppressed images showing diffuse oedema affecting the medial aspect of the distal thigh corresponding exactly with the radiation field. Note that although there is a hyperintense signal it does not have true mass effect.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2267691&req=5

Figure 7: Post-radiotherapy change. Coronal STIR and axial T2-weighted fat suppressed images showing diffuse oedema affecting the medial aspect of the distal thigh corresponding exactly with the radiation field. Note that although there is a hyperintense signal it does not have true mass effect.
Mentions: Post-radiation reactive changes demonstrate a high signal on T2-weighted sequences but are not usually associated with a mass lesion (Figs. 2 and 7). The oedema may be demonstrated in the subcutaneous tissue or tracking along the normal myofibrillar planes with a typical feathery pattern (Fig. 7). When this is identified, comparison with the T1-weighted sequences should demonstrate the ‘muscle texture sign’ to still be present. There are wide variations in the length of time it takes for this soft tissue oedema to resolve, however, it usually peaks at between 6 and 18 months following treatment and persists for between 2 and 4 years. The oedema tends to persist for longer around the intramuscular septa than in the fat or muscle itself and is more prominent for patients treated with neutron radiation than photon radiation. STIR sequences will identify this imaging finding for longer periods that T2-weighted sequences. Following radiation therapy, the thickness of the subcutaneous fat increases whereas the muscle size tends to decrease27. Post-operative fibrosis typically demonstrates low signal intensity on both T1- and T2-weighted sequences (similar to muscle) and shows little or no enhancement with gadolinium (Fig. 8)28.Figure 7

Bottom Line: The aim of follow-up imaging with any malignancy is to detect recurrence promptly so that treatment can be instigated at the earliest possible opportunity.The role of radiographs, computed tomography, magnetic resonance imaging and positron emission tomography is reviewed followed by a discussion on the imaging modalities useful in the detection of metastatic disease.Finally, we present a robust pathway that is suggested for the follow-up of patients with an extremity soft tissue sarcoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK. steven.james@roh.nhs.uk

ABSTRACT
Soft tissue sarcomas are uncommon malignancies that have a high risk of local recurrence despite adequate initial surgery. The aim of follow-up imaging with any malignancy is to detect recurrence promptly so that treatment can be instigated at the earliest possible opportunity. In this review article, we discuss the imaging modalities that can be employed to detect local recurrence following surgery for an extremity soft tissue sarcoma. The role of radiographs, computed tomography, magnetic resonance imaging and positron emission tomography is reviewed followed by a discussion on the imaging modalities useful in the detection of metastatic disease. Finally, we present a robust pathway that is suggested for the follow-up of patients with an extremity soft tissue sarcoma.

Show MeSH
Related in: MedlinePlus