Imaging in bone sarcomas. The chemotherapist's point of view

The role of imaging in planning oncologic treatment and follow-up of patients with bone sarcomas is discussed in the present article. Tumor staging and radiographic assessment of response to chemotherapy in bone sarcomas may be of difficult interpretation. In particular, the use of the criterion of tumor shrinkage to measure response to chemotherapy is not always applicable in bone tumors where higher calcification rather than reduction in size is frequently observed. New techniques such as (18)F-FDG PET/CT, dynamic contrast-enhanced computed tomography or magnetic resonance are now available allowing a more accurate staging of patients and adding information for the evaluation of tumor response. Innovative approaches aiming to evaluate vascular and metabolic response rather than mono- or bi-dimensional changes may be more informative and require further investigations.