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Non-Rhabdomyosarcoma (Non-RMS)






Local imaging

The tumor should be imaged prior to any biopsy to accurately assess the extent of disease.

MR scan

  • Best imaging modality to assess the extent of a soft tissue sarcoma
  • Primary tumor is typically:
    • Well circumscribed mass within or adjacent to muscle
  • Assess:
    • Diameter of tumor
    • Relationship to neurovascular bundle
    • Characteristics
    • T1
      • Intermediate to low signal intensity, similar to adjacent muscle
      • Heterogenous if hemorrhage, calcification, necrosis and myxoid material present
      • Enhancement of solid components with gadolinium
    • T2
      • Intermediate to high signal intensity
      • Heterogenous if hemorrhage, calcification, necrosis and myxoid material present


T1 sequence:


T2 sequence:



For intra-abdominal retroperitoneal and intrathoracic sarcomas, CT scan may give accurate information about the local extent of disease. 


Distant metastatic disease

CT scan

  • To exclude distant metastatic disease in lungs
  • To assess possible metastatic disease to liver and abdomen for liposarcoma


CT-PET scan

  • FDG positron emission tomography has not been used routinely in the assessment of follow up of pediatric non-RMS.
  • There is evidence in adult tumors that this modality can be used as part of initial staging. 
  • CT-PET allows high sensitivity for the detection of various sarcomas and accurate discrimination between newly diagnosed low-grade and high-grade sarcomas.
  • In one series over 90% of adult soft tissue sarcoma were FDG avid, but PET-CT results rarely changed managment.


The PET-CT above shows increased uptake in a non-RMS of the thigh.




References and Resources:

FDG PET/CT in Initial Staging of Adult Soft-Tissue Sarcoma. 
Sarcoma Volume 2012 (2012), Article ID 960194,David Roberge,Siavosh Vakilian,Yazan Z. Alabed,
Robert E. Turcotte,Carolyn R. Freeman, and Marc Hickeson

FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases.

Eur J Nucl Med Mol Imaging. 2009 Dec;36(12):1944-51. doi: 10.1007/s00259-009-1203-0.




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