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Sarcoma Diagnosis

 At Johns Hopkins, if a sarcoma is suspected, a radiographic image of the bone or soft-tissue area will be taken to confirm any abnormalities. Advances in imaging techniques have allowed physicians to see exactly where the tumor lies in the bone or soft tissue, and determine how aggressive it is.

Magnetic resonance imaging (MRI) is the main imaging source used for patients with bone or soft tissue sarcomas. Our radiologists are leaders in using a variety of MR techniques to detect and characterize musculoskeletal tumors, look for changes after chemotherapy and radiation, and find recurrent tumors after surgery. They also use additional, complementary tests including plain radiographs (X-rays), ultrasound and CT (computerized tomography) scans to show additional characteristics of the tumor, and to help determine if it has spread to any other areas. A bone scan (scintigraphy) or PET (positron emission tomography) scan may be used to detect areas of increased metabolism and can identify abnormal processes occurring in the bone or soft tissues, including sites of metastatic tumor.

View a movie of Johns Hopkins radiologist Laura Fayad, M.D., discussing MR imaging for the evaluation of musculoskeletal tumors, including the use of MR techniques for detection, characterization, determination of extent of disease, and the evaluation of musculoskeletal tumors following treatment.

Read a research paper describing these techniques.



A biopsy is necessary to identify the type of tumor. During a biopsy, a small piece of tissue or bone is removed to be studied under a microscope to look for cancer cells. It is vital that biopsies of bone and soft tissue sarcomas be done by a specialist with expertise in sarcoma imaging, to ensure that the biopsy is accurate and done in such a way that later surgical procedures are not compromised. Biopsy samples should then be studied by pathologists with expertise in sarcoma diagnosis, as is done at Johns Hopkins.

Leading cancer centers like Johns Hopkins can perform a biopsy using just a small amount of bone or tissue, retrieved via a needle. Radiologic scans including computerized tomography (CT), ultrasound, and fluoroscopy guide radiologists to place their needle in an area of the tumor with the highest chance of obtaining a diagnosis. Johns Hopkins radiologists are also studying MRI-guided biopsies that enhance images of the tissue or bone and may improve the accuracy of sarcoma biopsies.


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