Imaging Pediatric Bone Sarcomas

Tumors and Tumor-Like Conditions of Bone

“…Due to its association with rapid longitudinal growth, on average girls present earlier than boys, at 12 years of age versus 16. However, the tumor is slightly more common in males and also slightly more common in black children than in white children [ 9 ]. Serum alkaline phosphatase levels are elevated in about half of cases [ 16 ].…”

“…18F-fl uorodeoxyglucose positron emission tomography (FDG-PET) CT is a promising means to evaluate patients with bone sarcomas [ 9 , 10 ]. This technique may help predict tumor grade and assess treatment response when coupled with histologic evaluation [ 9 ].…”

“…Pathological fracture is uncommon except with the rare telangiectatic osteosarcoma [ 16 , 60 ]. Bone does not have lymphatic drainage, and the rare presence of tumor in regional lymph nodes portends a worse prognosis [ 9 ]. FDG-PET has not been shown to be more sensitive than bone scan in the detection of bony metastases in osteosarcoma.…”

“…Images must encompass the primary tumor site as well as the entire affected bone [ 9 ]. Overall, osteosarcoma is usually hypointense on T1-W images and hyperintense on STIR and other fl uid-sensitive sequences.…”

“…Non-contrast longitudinal T1-W images best determine the extent of intramedullary tumor; the longitudinal extent of the soft tissue mass usually corresponds to that of the intramedullary tumor. Epiphyseal extension of tumor must be assessed to facilitate appropriate surgical planning [ 9 ] (Fig. 21.22 ).…”