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Published on: August 25, 2017
[Pediatric sarcomas]
1Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland. ilias.tsiflikas@med.uni-tuebingen.de.
Clinical/Methodological Issue:
Pediatric sarcomas representing a rare, heterogenous group of highly malignant tumors. Due to their aggressiveness and complex anatomy during growth, precise imaging is essential for prognosis.
Standard Radiologic Methods:
Magnetic resonance imaging (MRI), using specific pediatric protocols (small field of view [FOV], thin slices), is the gold standard for local staging. Ultrasound is pivotal for primary diagnosis and biopsy planning, while low-dose chest computed tomography (CT) is used to assess pulmonary metastases.
Methodological Innovations:
Diffusion-weighted MRI and positron-emission tomography (PET)/MRI represents a low-radiation and highly efficient alternative to PET/CT for whole-body staging, especially for long-term aftercare.
Performance:
Imaging enables precise delineation of neurovascular structures and growth plates, forming the basis for limb-sparing surgical procedures. However, differentiating between vital residual tumor, recurrence, and posttherapeutic changes (scars, edema) remains challenging.
Achievements:
The consistent application of standardized study protocols and the interdisciplinary integration of radiology, oncology, and surgery are crucial for the success of modern therapeutic concepts.
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