Diagnostic imaging update: Soft tissue sarcomas

Background: No single imaging approach is ideal for every tumor. While radiography can be effective for diagnosis of specific tumors, additional imaging is often required. Soft tissue sarcomas require a multimodality approach. Methods: The authors discuss the general imaging approaches for patients who present with soft tissue masses, the fundamental principles inherent to tumor imaging, and the specific applications of newer imaging modalities. Results: Magnetic resonance imaging has emerged as the preferred technique for evaluating soft tissue tumors but is limited in demonstrating the pattern of soft tissue calcification. Computed tomography is the best modality for evaluating osseous architecture and for patients who cannot be evaluated with MRI. PET is helpful in metabolic imaging, and ultrasonography is useful in differentiating cystic from solid masses. Magnetic resonance angiography accurately reveals the arterial and venous supply of vascular tumors. Conclusions: Current imaging techniques provide numerous noninvasive methods to diagnose and stage suspected soft tissue sarcomas.