Imaging recommendations for soft-tissue sarcomas: model guidelines from diagnosis to post-treatment follow-up

Soft-tissue sarcomas (STSs) are a heterogeneous group of malignancies of mesenchymal origin with an incidence of 4-8 per 100,000 within Europe; they consist of various subtypes, each expressing distinct morphological, histopathological, and molecular features. According to the 2020 World Health Organization (WHO) classification, STSs are divided into 11 broad categories comprising approximately 80 entities. STS management guidelines are constantly evolving due to the development of newer diagnostic methods and treatments including the discovery of new chemotherapeutic agents and immunomodulators. Although the referral, diagnostic, and management pathways may vary in different healthcare systems, the core management principles remain the same. This article explores various established STS guidelines on imaging diagnosis, staging, and follow-up by international societies. It also describes radiologic utility in assessing recurrence and postoperative mimics. The objective is to provide radiologists and clinicians with imaging guidance useful at various stages of STS management.