Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?

Autor: Noebauer-Huhmann IM; Department of Biomedical Imaging and Image Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria. iris.noebauer@meduniwien.ac.at., Vanhoenacker FM; Department of Radiology AZ Sint Maarten Mechelen, University Hospital Antwerp, Antwerp, Belgium.; Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium., Vilanova JC; Department of Radiology, Clínica Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain., Tagliafico AS; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.; Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Weber MA; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany., Lalam RK; Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK., Grieser T; Dept. for Diagnostic and Interventional, Radiology University Hospital Augsburg, Augsburg, Germany., Nikodinovska VV; Medical Faculty, Ss. Cyril and Methodius University, Skopje, Macedonia.; Department of Radiology, University Surgical Clinic 'St. Naum Ohridski' Skopje, Skopje, Macedonia., de Rooy JWJ; Department of Imaging, Radiology, Radboud University Medical Center, Nijmegen, The Netherlands., Papakonstantinou O; 2Nd Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece., Mccarthy C; Oxford Musculoskeletal Radiology and Oxford University Hospitals, Oxford, UK., Sconfienza LM; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.; Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy., Verstraete K; Department of Radiology, Ghent University Hospital, Ghent, Belgium., Martel-Villagrán J; Radiology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Szomolanyi P; High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria.; Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia., Lecouvet FE; Department of Radiology and Medical Imaging, Cliniques Universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium., Afonso D; Hospital Particular da Madeira, and Hospital da Luz Lisboa, Lisbon, Portugal., Albtoush OM; Department of Radiology, University of Jordan, Ammam, Jordan., Aringhieri G; Academic Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy., Arkun R; Ege University Medical School Izmir, Izmir, Turkey Star Imaging Center Izmir, Izmir, Turkey., Aström G; Department of Immunology, Genetics and Pathology (Oncology) and Department of Surgical Sciences (Radiology), Uppsala University, Uppsala, Sweden., Bazzocchi A; Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Botchu R; Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK., Breitenseher M; Sigmund Freud Privatuniversität, Vienna, Austria., Chaudhary S; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Dalili D; Academic Surgical Unit, South West London Elective Orthopaedic Centre (SWLEOC), London, UK., Davies M; Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK., de Jonge MC; Department of Radiology, St. Antonius Hospital, Utrecht, The Netherlands., Mete BD; Department of Radiology School of Medicine, Izmir Demokrasi University, Izmir, Turkey., Fritz J; Department of Radiology, NYU Grossman School of Medicine, New York, USA.; Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany., Gielen JLMA; Department of Radiology and Medical Imaging, University Hospital Antwerp, Edegem, Belgium., Hide G; Department of Radiology, Freeman Hospital, Newcastle Upon Tyne, UK., Isaac A; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK., Ivanoski S; St. Erasmo Hospital for Orthopaedic Surgery and Traumatology Ohrid, Ohrid, Macedonia., Mansour RM; Oxford University Hospitals, Oxford, UK., Muntaner-Gimbernat L; Hospital Univeritario Son Espases Balearic Islands University, Palma, Spain., Navas A; Department of Radiology, Division of Musculoskeletal Radiology, Leiden University Medical Center, Leiden, The Netherlands., O Donnell P; Royal National Orthopaedic Hospital, Stanmore, UK., Örgüç Ş; Manisa Celal Bayar University, Manisa, Turkey., Rennie W; Clinical MSK Radiology, Loughborough University, Leicester Royal Infirmary, Leicester, UK., Resano S; Hospital Universitario Ramón y Cajal, Madrid, Spain., Robinson P; Musculoskeletal Radiology Department Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds, UK., Sanal HT; Radiology Department, University of Health Sciences, Gülhane Training and Research Hospital, Istanbul, Turkey., Ter Horst SAJ; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands., van Langevelde K; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Wörtler K; Musculoskeletal Radiology Section, Klinikum Rechts der Isar, Technical University of Munich - TUM School of Medicine, Munich, Germany., Koelz M; Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria., Panotopoulos J; Departement of Orthopaedics and Traumatology, Division of Orthopaedics, Medical University of Vienna, Vienna, Austria., Windhager R; Departement of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria., Bloem JL; Department of Radiology, LUMC, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2024 Jul; Vol. 34 (7), pp. 4427-4437. Date of Electronic Publication: 2023 Dec 07.
DOI: 10.1007/s00330-023-10425-5
Abstrakt: Objectives: Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary. The guidelines are intended to support radiologists in their decision-making and contribute to interdisciplinary tumor board discussions.
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 were scored online by level of agreement (0 to 10) during two iterative rounds. Either "group consensus," "group agreement," or "lack of agreement" was achieved.
Results: Eight sections were defined that finally contained 145 statements with comments. Overall, group consensus was reached in 95.9%, and group agreement in 4.1%. This communication contains the first part consisting of the imaging algorithm for suspected soft tissue tumors, methods for local imaging, and the role of tumor centers.
Conclusion: Ultrasound represents the initial triage imaging modality for accessible and small tumors. MRI is the modality of choice for the characterization and local staging of most soft tissue tumors. CT is indicated in special situations. In suspicious or likely malignant tumors, a specialist tumor center should be contacted for referral or teleradiologic second opinion. This should be done before performing a biopsy, without exception.
Clinical Relevance: The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability both in individual patients and in future studies on individualized strategies.
Key Points: • Ultrasound remains the best initial triage imaging modality for accessible and small suspected soft tissue tumors. • MRI is the modality of choice for the characterization and local staging of soft tissue tumors in most cases; CT is indicated in special situations. Suspicious or likely malignant tumors should undergo biopsy. • In patients with large, indeterminate or suspicious tumors, a tumor reference center should be contacted for referral or teleradiologic second opinion; this must be done before a biopsy.
(© 2023. The Author(s).)
Databáze: MEDLINE
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