Daniel Vanel MD, Presenter: Nothing to Disclose

1) Understand the reasons of the frequent recurrences of soft tissue sarcomas. 2) Select the best MRI sequences to detect recurrences, especially the role of dynamic imaging. 3) Select the best imaging schedule to follow the patients. 4) Understand the specific problems of imaging isolated limb perfusion in soft tissue sarcomas.

Soft tissue sarcomas are 100 times rarer than benign tumors. They often grow slowly and look well limited. The general surgeon, not used to the problem, , often treats sarcoma as a benign lesion by very limited resection, leaving a part of the tumor. Recurrences are very frequent, and their detection a common problem. MRI is the exam to use. T2W sequence is the first to use. If everything has a low signal, there is no recurrence. Diffuse high signal lesions without a mass, usually indicate radiation induced changes. A high signal intensity mass requires contrat medium injection, to differentiate recurrences and sequel masses. Dynamic studies may be useful in difficult cases. The best schedule is not known, and a control every six months is often proposed. In the limbs, only a clinical control may be more efficient, MR being performed only if clinical suspiction. After isolated limb perfusion, dynamic MR is the gold standard to evaluate the patients.

Vanel, D, Imaging of MSK Tumors after Treatment.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000535.html