Soft tissue tumor imaging in adults: whole-body staging in sarcoma, non-malignant entities requiring special algorithms, pitfalls and special imaging aspects. Guidelines 2024 from the European Society of Musculoskeletal Radiology (ESSR)
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| Title: | Soft tissue tumor imaging in adults: whole-body staging in sarcoma, non-malignant entities requiring special algorithms, pitfalls and special imaging aspects. Guidelines 2024 from the European Society of Musculoskeletal Radiology (ESSR) |
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| Authors: | Noebauer-Huhmann, Iris-Melanie, Vanhoenacker, Filip M., Vilanova, Joan C., Tagliafico, Alberto S., Weber, Marc-Andre, Lalam, Radhesh K., Grieser, Thomas, Nikodinovska, Violeta Vasilevska, de Rooy, Jacky W.J., Papakonstantinou, Olympia, Mccarthy, Catherine, Sconfienza, Luca Maria, Verstraete, Koenraad, Martel-Villagran, Jose, Szomolanyi, Pavol, Lecouvet, Frederic E., Afonso, Diana, Albtoush, Omar M., Aringhieri, Giacomo, Arkun, Remide, Astrom, Gunnar, Bazzocchi, Alberto, Botchu, Rajesh, Breitenseher, Martin, Chaudhary, Snehansh, Dalili, Danoob, Davies, Mark, de Jonge, Milko C., Mete, Berna D., Fritz, Jan, Gielen, Jan L.MA., Hide, Geoff, Isaac, Amanda, Ivanoski, Slavcho, Mansour, Ramy M., Muntaner-Gimbernat, Lorenzo, Navas, Ana, O'Donnell, Paul, Orguc, Sebnem, Rennie, Winston J., Resano, Santiago, Robinson, Philip, Sanal, Hatice T., Ter Horst, Simone A.J., van Langevelde, Kirsten, Woertler, Klaus, Koelz, Marita, Panotopoulos, Joannis, Windhager, Reinhard, Bloem, Johan L. |
| Contributors: | MS Radiologie, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - (SLuc) Service de radiologie |
| Source: | Eur Radiol European Radiology, 35, 1, pp. 351-359 European radiology, Vol. 35, no.1, p. 351-359 (2025) European radiology EUROPEAN RADIOLOGY |
| Publisher Information: | Springer Science and Business Media LLC, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | Adult, MYXOID LIPOSARCOMA, Practice guideline, Consensus, Delphi Technique, PET/CT, FEATURES, Soft Tissue Neoplasms, Review, Connective and soft tissue, Neoplasms, Medical Imaging - Radboud University Medical Center, Medicine and Health Sciences, Humans, DIAGNOSTIC-ACCURACY, Whole Body Imaging, EXTREMITY, Algorithms [MeSH], Europe [MeSH], Sarcoma/diagnostic imaging [MeSH], Adult [MeSH], Soft Tissue Neoplasms/pathology [MeSH], Humans [MeSH], Neoplasm Staging [MeSH], Whole Body Imaging/methods [MeSH], Societies, Medical [MeSH], Sarcoma/pathology [MeSH], Magnetic Resonance Imaging/methods [MeSH], Delphi Technique [MeSH], Diagnostic imaging, Soft Tissue Neoplasms/diagnostic imaging [MeSH], PART SARCOMA, Societies, Medical, Neoplasm Staging, Computer. Automation, ddc:610, Science & Technology, Radiology, Nuclear Medicine & Medical Imaging, LYMPH-NODE METASTASIS, 3202 Clinical sciences, 1103 Clinical Sciences, Sarcoma, 16. Peace & justice, Magnetic Resonance Imaging, ddc, 3. Good health, Europe, Nuclear Medicine & Medical Imaging, Radiology Nuclear Medicine and imaging, PATTERNS, NERVE SHEATH TUMOR, Human medicine, Life Sciences & Biomedicine, Algorithms, MRI |
| Description: | Objectives The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls. Materials and methods A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements that had undergone interdisciplinary revision were scored online by the level of agreement (0 to 10) during two iterative rounds, that could result in ‘group consensus’, ‘group agreement’, or ‘lack of agreement’. Results The three sections contain 24 statements with comments. Group consensus was reached in 95.8% and group agreement in 4.2%. For whole-body staging, pulmonary MDCT should be performed in all high-grade sarcomas. Whole-body MRI is preferred for staging bone metastasis, with [18F]FDG-PET/CT as an alternative modality in PET-avid tumors. Patients with alveolar soft part sarcoma, clear cell sarcoma, and angiosarcoma should be screened for brain metastases. Special algorithms are recommended for entities such as rhabdomyosarcoma, extraskeletal Ewing sarcoma, myxoid liposarcoma, and neurofibromatosis type 1 associated malignant peripheral nerve sheath tumors. Satisfaction of search should be avoided in potential multiplicity. Conclusion Standardized whole-body staging includes pulmonary MDCT in all high-grade sarcomas; entity-dependent modifications and specific algorithms are recommended for sarcomas and non-malignant soft tissue tumors. Clinical relevance statement These updated ESSR soft tissue tumor imaging guidelines aim to provide support in decision-making, helping to avoid common pitfalls, by providing general and entity-specific algorithms, techniques, and reporting recommendations for whole-body staging in sarcoma and non-malignant soft tissue tumors. Key Points An early, accurate, diagnosis is crucial for the prognosis of patients with soft tissue tumors. These updated guidelines provide best practice expert consensus for standardized imaging algorithms, techniques, and reporting. Standardization can improve the comparability examinations and provide databases for large data analysis. |
| Document Type: | Article Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1432-1084 |
| DOI: | 10.1007/s00330-024-10897-z |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/39030374 https://hdl.handle.net/https://repository.ubn.ru.nl/handle/2066/313646 https://dspace.library.uu.nl/handle/1874/458157 https://repository.ubn.ru.nl//bitstream/handle/2066/313646/313646.pdf https://hdl.handle.net/2066/313646 https://hdl.handle.net/2078.1/300512 https://hdl.handle.net/10067/2069230151162165141 https://repository.uantwerpen.be/docstore/d:irua:24404 https://pergamos.lib.uoa.gr/uoa/dl/object/3499128 https://repository.publisso.de/resource/frl:6520463 https://biblio.ugent.be/publication/01J3R3WCA907X8P6R45E6ZRP85 http://hdl.handle.net/1854/LU-01J3R3WCA907X8P6R45E6ZRP85 http://doi.org/10.1007/s00330-024-10897-z https://biblio.ugent.be/publication/01J3R3WCA907X8P6R45E6ZRP85/file/01JPJCRCP41YBY6SBYV6HD0KG9 https://mediatum.ub.tum.de/1770849 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....f279e8359722d7f93203efbe38a5083c |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Objectives The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls. Materials and methods A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements that had undergone interdisciplinary revision were scored online by the level of agreement (0 to 10) during two iterative rounds, that could result in ‘group consensus’, ‘group agreement’, or ‘lack of agreement’. Results The three sections contain 24 statements with comments. Group consensus was reached in 95.8% and group agreement in 4.2%. For whole-body staging, pulmonary MDCT should be performed in all high-grade sarcomas. Whole-body MRI is preferred for staging bone metastasis, with [18F]FDG-PET/CT as an alternative modality in PET-avid tumors. Patients with alveolar soft part sarcoma, clear cell sarcoma, and angiosarcoma should be screened for brain metastases. Special algorithms are recommended for entities such as rhabdomyosarcoma, extraskeletal Ewing sarcoma, myxoid liposarcoma, and neurofibromatosis type 1 associated malignant peripheral nerve sheath tumors. Satisfaction of search should be avoided in potential multiplicity. Conclusion Standardized whole-body staging includes pulmonary MDCT in all high-grade sarcomas; entity-dependent modifications and specific algorithms are recommended for sarcomas and non-malignant soft tissue tumors. Clinical relevance statement These updated ESSR soft tissue tumor imaging guidelines aim to provide support in decision-making, helping to avoid common pitfalls, by providing general and entity-specific algorithms, techniques, and reporting recommendations for whole-body staging in sarcoma and non-malignant soft tissue tumors. Key Points An early, accurate, diagnosis is crucial for the prognosis of patients with soft tissue tumors. These updated guidelines provide best practice expert consensus for standardized imaging algorithms, techniques, and reporting. Standardization can improve the comparability examinations and provide databases for large data analysis. |
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| ISSN: | 14321084 |
| DOI: | 10.1007/s00330-024-10897-z |