Sarcoma

Sarcomas are a diverse group of malignancies originating in the connective tissue. The approach of a patient with a mass suspect for sarcoma starts with performing a biopsy to obtain tissue for evaluation by pathology. The main role of the current imaging modalities, in general, is to recognize patients with typically benign disease, in whom further invasive staging can be omitted, and select patients with a suspected malignancy, who should be referred for biopsy. Since soft tissue sarcoma tends to be large and heterogeneous, there is growing interest in using imaging modalities to guide these biopsies. Together with pathology, imaging modalities are the basis for accurate staging, evaluation of locoregional extent of the primary lesion, screening for occult metastases, evaluation of response to cancer treatment, and the detection of tumor recurrence. In this chapter, an overview is given of the use of 18F-FDG PET in these settings, its strengths as well as its limitations.