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Semin Musculoskelet Radiol 2020; 24(06): 627-644
DOI: 10.1055/s-0040-1721464
Review Article

Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence

Iris-M. Noebauer-Huhmann
1   Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
,
Snehansh R. Chaudhary
2   Department of Clinical Radiology, Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
,
Olympia Papakonstantinou
3   2nd Department of Radiology, National University of Athens, “Attikon” Hospital, Athens, Greece
,
Joannis Panotopoulos
4   Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, Vienna, Austria
,
Marc-André Weber
5   Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
,
Radhesh K. Lalam
6   Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
,
Omar M. Albtoush
7   Department of Radiology, University of Jordan, and Department of Radiology, King Hussein Cancer Center, Amman, Jordan
,
Barbara J. Fueger
8   Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
,
Pavol Szomolanyi
9   High Field MR Center, Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
,
Thomas Grieser
10   Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
,
Johan L. Bloem
11   Department of radiology, Leiden University Medical Center, Leiden, The Netherlands
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Erratum: Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from RecurrenceSemin Musculoskelet Radiol 2020; 24(06): e1-e1
DOI: 10.1055/s-0040-1722295

Abstract

Soft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations. Prerequisite is a precise knowledge of the current clinical management and surgical techniques. We review recurrence rates and treatment modalities. An adequate imaging technique is paramount, and comparison with previous imaging is highly recommended. We describe time-dependent therapy-related complications on magnetic resonance imaging compared with the spectrum of regular post-therapeutic changes. Early complications such as seromas, hematomas, and infections, late complications such as edema and fibrosis, and inflammatory pseudotumors are elucidated. The appearance of recurrences and radiation-associated sarcomas is contrasted with these changes. This systematic approach in follow-up imaging of soft tissue sarcoma patients will facilitate the differentiation of post-therapeutic changes from recurrences.

Keywords

sarcoma - recurrence - aftercare - magnetic resonance imaging - postoperative complications


Publication History

Article published online:
11 December 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Callegaro D, Miceli R, Mariani L, Raut CP, Gronchi A. Soft tissue sarcoma nomograms and their incorporation into practice. Cancer 2017; 123 (15) 2802-2820
    CrossrefPubMedGoogle Scholar
  • 2 Coindre JM, Terrier P, Bui NB. et al. Prognostic factors in adult patients with locally controlled soft tissue sarcoma. A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group. J Clin Oncol 1996; 14 (03) 869-877
    CrossrefPubMedGoogle Scholar
  • 3 Felderhof JM, Creutzberg CL, Putter H. et al. Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy. Acta Oncol 2013; 52 (04) 745-752
    CrossrefPubMedGoogle Scholar
  • 4 Gronchi A, Lo Vullo S, Colombo C. et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010; 251 (03) 506-511
    CrossrefPubMedGoogle Scholar
  • 5 Vanhoenacker FM, Van Looveren K, Trap K. et al. Grading and characterization of soft tissue tumors on magnetic resonance imaging: the value of an expert second opinion report. Insights Imaging 2012; 3 (02) 131-138
    CrossrefPubMedGoogle Scholar
  • 6 Gantzer J, Di Marco A, Fabacher T. et al. Conformity to clinical practice guidelines at initial management in adult soft tissue and visceral tumors since the implementation of the NetSarc Network in eastern France. Oncologist 2019; 24 (08) e775-e783
    CrossrefPubMedGoogle Scholar
  • 7 Sekimizu M, Ogura K, Yasunaga H. et al. Development of nomograms for prognostication of patients with primary soft tissue sarcomas of the trunk and extremity: report from the Bone and Soft Tissue Tumor Registry in Japan. BMC Cancer 2019; 19 (01) 657
    CrossrefPubMedGoogle Scholar
  • 8 Zagars GK, Ballo MT, Pisters PW. et al. Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer 2003; 97 (10) 2530-2543
    CrossrefPubMedGoogle Scholar
  • 9 Italiano A, Le Cesne A, Mendiboure J. et al. Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft-tissue sarcoma patients in the competing risks setting. Cancer 2014; 120 (21) 3361-3369
    CrossrefPubMedGoogle Scholar
  • 10 Toulmonde M, Le Cesne A, Mendiboure J. et al. Long-term recurrence of soft tissue sarcomas: prognostic factors and implications for prolonged follow-up. Cancer 2014; 120 (19) 3003-3006
    CrossrefPubMedGoogle Scholar
  • 11 Gronchi A, Strauss DC, Miceli R. et al. Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (RPS): a report on 1007 patients from the multi-institutional collaborative RPS Working Group. Ann Surg 2016; 263 (05) 1002-1009
    CrossrefPubMedGoogle Scholar
  • 12 Smith HG, Memos N, Thomas JM, Smith MJ, Strauss DC, Hayes AJ. Patterns of disease relapse in primary extremity soft-tissue sarcoma. Br J Surg 2016; 103 (11) 1487-1496
    CrossrefPubMedGoogle Scholar
  • 13 Novais EN, Demiralp B, Alderete J, Larson MC, Rose PS, Sim FH. Do surgical margin and local recurrence influence survival in soft tissue sarcomas?. Clin Orthop Relat Res 2010; 468 (11) 3003-3011
    CrossrefPubMedGoogle Scholar
  • 14 Gerrand CH, Bell RS, Wunder JS. et al. The influence of anatomic location on outcome in patients with soft tissue sarcoma of the extremity. Cancer 2003; 97 (02) 485-492
    CrossrefPubMedGoogle Scholar
  • 15 Qureshi YA, Huddy JR, Miller JD, Strauss DC, Thomas JM, Hayes AJ. Unplanned excision of soft tissue sarcoma results in increased rates of local recurrence despite full further oncological treatment. Ann Surg Oncol 2012; 19 (03) 871-877
    CrossrefPubMedGoogle Scholar
  • 16 Wang L, Pretell-Mazzini J, Kerr DA. et al. MRI findings associated with microscopic residual tumor following unplanned excision of soft tissue sarcomas in the extremities. Skeletal Radiol 2018; 47 (02) 181-190
    CrossrefPubMedGoogle Scholar
  • 17 Sawamura C, Matsumoto S, Shimoji T, Tanizawa T, Ae K. What are risk factors for local recurrence of deep high-grade soft-tissue sarcomas?. Clin Orthop Relat Res 2012; 470 (03) 700-705
    CrossrefPubMedGoogle Scholar
  • 18 Traub F, Griffin AM, Wunder JS, Ferguson PC. Influence of unplanned excisions on the outcomes of patients with stage III extremity soft-tissue sarcoma. Cancer 2018; 124 (19) 3868-3875
    CrossrefPubMedGoogle Scholar
  • 19 Sabolch A, Feng M, Griffith K. et al. Risk factors for local recurrence and metastasis in soft tissue sarcomas of the extremity. Am J Clin Oncol 2012; 35 (02) 151-157
    CrossrefPubMedGoogle Scholar
  • 20 Trovik CS, Bauer HC, Alvegård TA. et al. Surgical margins, local recurrence and metastasis in soft tissue sarcomas: 559 surgically-treated patients from the Scandinavian Sarcoma Group Register. Eur J Cancer 2000; 36 (06) 710-716
    CrossrefPubMedGoogle Scholar
  • 21 Alamanda VK, Crosby SN, Archer KR, Song Y, Schwartz HS, Holt GE. Predictors and clinical significance of local recurrence in extremity soft tissue sarcoma. Acta Oncol 2013; 52 (04) 793-802
    CrossrefPubMedGoogle Scholar
  • 22 Stojadinovic A, Leung DH, Hoos A, Jaques DP, Lewis JJ, Brennan MF. Analysis of the prognostic significance of microscopic margins in 2,084 localized primary adult soft tissue sarcomas. Ann Surg 2002; 235 (03) 424-434
    CrossrefPubMedGoogle Scholar
  • 23 Daigeler A, Zmarsly I, Hirsch T. et al. Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma. Br J Cancer 2014; 110 (06) 1456-1464
    CrossrefPubMedGoogle Scholar
  • 24 Liu CY, Yen CC, Chen WM. et al. Soft tissue sarcoma of extremities: the prognostic significance of adequate surgical margins in primary operation and reoperation after recurrence. Ann Surg Oncol 2010; 17 (08) 2102-2111
    CrossrefPubMedGoogle Scholar
  • 25 Gundle KR, Gupta S, Kafchinski L. et al. An analysis of tumor- and surgery-related factors that contribute to inadvertent positive margins following soft tissue sarcoma resection. Ann Surg Oncol 2017; 24 (08) 2137-2144
    CrossrefPubMedGoogle Scholar
  • 26 Shapeero LG, De Visschere PJ, Verstraete KL. et al. Post-treatment complications of soft tissue tumours. Eur J Radiol 2009; 69 (02) 209-221
    CrossrefPubMedGoogle Scholar
  • 27 Lazarides AL, Kerr DL, Nussbaum DP. et al. Soft tissue sarcoma of the extremities: what is the value of treating at high-volume centers?. Clin Orthop Relat Res 2019; 477 (04) 718-727
    CrossrefPubMedGoogle Scholar
  • 28 Benson C, Judson I. Role of expert centres in the management of sarcomas—a UK perspective. Eur J Cancer 2014; 50 (11) 1951-1956
    CrossrefPubMedGoogle Scholar
  • 29 Bagaria SP, Chang YH, Gray RJ, Ashman JB, Attia S, Wasif N. Improving long-term outcomes for patients with extra-abdominal soft tissue sarcoma regionalization to high-volume centers, improved compliance with guidelines or both?. Sarcoma 2018; 2018: 8141056
    CrossrefPubMedGoogle Scholar
  • 30 Salas S, Stoeckle E, Collin F. et al. Superficial soft tissue sarcomas (S-STS): a study of 367 patients from the French Sarcoma Group (FSG) database. Eur J Cancer 2009; 45 (12) 2091-2102
    CrossrefPubMedGoogle Scholar
  • 31 Eilber FC, Rosen G, Nelson SD. et al. High-grade extremity soft tissue sarcomas: factors predictive of local recurrence and its effect on morbidity and mortality. Ann Surg 2003; 237 (02) 218-226
    CrossrefPubMedGoogle Scholar
  • 32 Grobmyer SR, Brennan MF. Predictive variables detailing the recurrence rate of soft tissue sarcomas. Curr Opin Oncol 2003; 15 (04) 319-326
    CrossrefPubMedGoogle Scholar
  • 33 Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg 2003; 238 (03) 358-370 ; discussion 370–371
    CrossrefPubMedGoogle Scholar
  • 34 Peterson JJ, Kransdorf MJ, Bancroft LW, O'Connor MI. Malignant fatty tumors: classification, clinical course, imaging appearance and treatment. Skeletal Radiol 2003; 32 (09) 493-503
    CrossrefPubMedGoogle Scholar
  • 35 Zagars GK, Ballo MT, Pisters PW, Pollock RE, Patel SR, Benjamin RS. Prognostic factors for disease-specific survival after first relapse of soft-tissue sarcoma: analysis of 402 patients with disease relapse after initial conservative surgery and radiotherapy. Int J Radiat Oncol Biol Phys 2003; 57 (03) 739-747
    CrossrefPubMedGoogle Scholar
  • 36 Nakamura T, Abudu A, Murata H. et al. Oncological outcome of patients with deeply located soft tissue sarcoma of the pelvis: a follow up study at minimum 5 years after diagnosis. Eur J Surg Oncol 2013; 39 (09) 1030-1035
    CrossrefPubMedGoogle Scholar
  • 37 Abatzoglou S, Turcotte RE, Adoubali A, Isler MH, Roberge D. Local recurrence after initial multidisciplinary management of soft tissue sarcoma: is there a way out?. Clin Orthop Relat Res 2010; 468 (11) 3012-3018
    CrossrefPubMedGoogle Scholar
  • 38 Willems SM, Debiec-Rychter M, Szuhai K, Hogendoorn PC, Sciot R. Local recurrence of myxofibrosarcoma is associated with increase in tumour grade and cytogenetic aberrations, suggesting a multistep tumour progression model. Mod Pathol 2006; 19 (03) 407-416
    CrossrefPubMedGoogle Scholar
  • 39 Fox MG, Bancroft LW, Peterson JJ, Kransdorf MJ, Terkonda SP, O'Connor MI. MRI appearance of myocutaneous flaps commonly used in orthopedic reconstructive surgery. AJR Am J Roentgenol 2006; 187 (03) 800-806
    CrossrefPubMedGoogle Scholar
  • 40 Magerkurth O, Girish G, Jacobson JA. et al. MR imaging appearances of soft tissue flaps following reconstructive surgery of the lower extremity. Korean J Radiol 2015; 16 (01) 160-168
    CrossrefPubMedGoogle Scholar
  • 41 Ghert MA, Davis AM, Griffin AM. et al. The surgical and functional outcome of limb-salvage surgery with vascular reconstruction for soft tissue sarcoma of the extremity. Ann Surg Oncol 2005; 12 (12) 1102-1110
    CrossrefPubMedGoogle Scholar
  • 42 Parrett BM, Talbot SG, Pribaz JJ, Lee BT. A review of local and regional flaps for distal leg reconstruction. J Reconstr Microsurg 2009; 25 (07) 445-455
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Summer T, Bota O, Armbruster R, Münchow S, Dragu A. Soft tissue defects following tumor resection in the limbs and trunk: plastic reconstructive soft tissue and revision concepts. [in German]. Orthopade 2020; 49 (02) 169-176
    CrossrefPubMedGoogle Scholar
  • 44 Wortman JR, Tirumani SH, Jagannathan JP. et al. Radiation therapy for soft-tissue sarcomas: a primer for radiologists. Radiographics 2016; 36 (02) 554-572
    CrossrefPubMedGoogle Scholar
  • 45 Jebsen NL, Trovik CS, Bauer HC. et al. Radiotherapy to improve local control regardless of surgical margin and malignancy grade in extremity and trunk wall soft tissue sarcoma: a Scandinavian sarcoma group study. Int J Radiat Oncol Biol Phys 2008; 71 (04) 1196-1203
    CrossrefPubMedGoogle Scholar
  • 46 Sampath S, Hitchcock YJ, Shrieve DC, Randall RL, Schultheiss TE, Wong JY. Radiotherapy and extent of surgical resection in retroperitoneal soft-tissue sarcoma: multi-institutional analysis of 261 patients. J Surg Oncol 2010; 101 (05) 345-350
    CrossrefPubMedGoogle Scholar
  • 47 Davis AM, O'Sullivan B, Turcotte R. et al; Canadian Sarcoma Group, NCI Canada Clinical Trial Group Randomized Trial. Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother Oncol 2005; 75 (01) 48-53
    CrossrefPubMedGoogle Scholar
  • 48 O'Sullivan B, Davis A. Five-year results of a randomized phase III trial of pre-operative vs postoperative radiotherapy in extremity soft tissue sarcoma. J Clin Oncol 2004;22(9007):
    PubMedGoogle Scholar
  • 49 Choong PF, Petersen IA, Nascimento AG, Sim FH. Is radiotherapy important for low-grade soft tissue sarcoma of the extremity?. Clin Orthop Relat Res 2001; (387) 191-199
    CrossrefPubMedGoogle Scholar
  • 50 Kraus-Tiefenbacher US, Van Kampen M. Current trends in radiotherapy following surgical resection of soft-tissue sarcoma of the extremities and trunk. [in German]. Handchir Mikrochir Plast Chir 2015; 47 (02) 128-133
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Zagars GK, Ballo MT, Pisters PW, Pollock RE, Patel SR, Benjamin RS. Preoperative vs. postoperative radiation therapy for soft tissue sarcoma: a retrospective comparative evaluation of disease outcome. Int J Radiat Oncol Biol Phys 2003; 56 (02) 482-488
    CrossrefPubMedGoogle Scholar
  • 52 O'Sullivan B, Davis AM, Turcotte R. et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 2002; 359 (9325): 2235-2241
    CrossrefPubMedGoogle Scholar
  • 53 Barkley Jr HT, Martin RG, Romsdahl MM, Lindberg R, Zagars GK. Treatment of soft tissue sarcomas by preoperative irradiation and conservative surgical resection. Int J Radiat Oncol Biol Phys 1988; 14 (04) 693-699
    CrossrefPubMedGoogle Scholar
  • 54 Cannon CP, Ballo MT, Zagars GK. et al. Complications of combined modality treatment of primary lower extremity soft-tissue sarcomas. Cancer 2006; 107 (10) 2455-2461
    CrossrefPubMedGoogle Scholar
  • 55 Slump J, Bastiaannet E, Halka A. et al. Risk factors for postoperative wound complications after extremity soft tissue sarcoma resection: a systematic review and meta-analyses. J Plast Reconstr Aesthet Surg 2019; 72 (09) 1449-1464
    CrossrefPubMedGoogle Scholar
  • 56 Kepka L, DeLaney TF, Suit HD, Goldberg SI. Results of radiation therapy for unresected soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 2005; 63 (03) 852-859
    CrossrefPubMedGoogle Scholar
  • 57 Brodowicz T, Schwameis E, Widder J. et al. Intensified adjuvant IFADIC chemotherapy for adult soft tissue sarcoma: a prospective randomized feasibility trial. Sarcoma 2000; 4 (04) 151-160
    CrossrefPubMedGoogle Scholar
  • 58 Woll PJ, Reichardt P, Le Cesne A. et al; EORTC Soft Tissue and Bone Sarcoma Group and the NCIC Clinical Trials Group Sarcoma Disease Site Committee. Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicentre randomised controlled trial. Lancet Oncol 2012; 13 (10) 1045-1054
    CrossrefPubMedGoogle Scholar
  • 59 Frustaci S, Gherlinzoni F, De Paoli A. et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol 2001; 19 (05) 1238-1247
    CrossrefPubMedGoogle Scholar
  • 60 Chou YS, Liu CY, Chen WM. et al. Follow-up after primary treatment of soft tissue sarcoma of extremities: impact of frequency of follow-up imaging on disease-specific survival. J Surg Oncol 2012; 106 (02) 155-161
    CrossrefPubMedGoogle Scholar
  • 61 Cheney MD, Giraud C, Goldberg SI. et al. MRI surveillance following treatment of extremity soft tissue sarcoma. J Surg Oncol 2014; 109 (06) 593-596
    CrossrefPubMedGoogle Scholar
  • 62 Hovgaard TB, Nymark T, Skov O, Petersen MM. Follow-up after initial surgical treatment of soft tissue sarcomas in the extremities and trunk wall. Acta Oncol 2017; 56 (07) 1004-1012
    CrossrefPubMedGoogle Scholar
  • 63 Park JW, Yoo HJ, Kim HS. et al. MRI surveillance for local recurrence in extremity soft tissue sarcoma. Eur J Surg Oncol 2019; 45 (02) 268-274
    CrossrefPubMedGoogle Scholar
  • 64 George A, Grimer RJ, James SLJ. Could routine magnetic resonance imaging detect local recurrence of musculoskeletal sarcomas earlier? a cost-effectiveness study. Indian J Orthop 2018; 52 (01) 81-86
    CrossrefPubMedGoogle Scholar
  • 65 Hirschmann A, van Praag VM, Haas RL, van de Sande MAJ, Bloem JL. Can we use MRI to detect clinically silent recurrent soft-tissue sarcoma?. Eur Radiol 2020; 30 (09) 4724-4733
    CrossrefPubMedGoogle Scholar
  • 66 Patel SA, Royce TJ, Barysauskas CM, Thornton KA, Raut CP, Baldini EH. Surveillance imaging patterns and outcomes following radiation therapy and radical resection for localized extremity and trunk soft tissue sarcoma. Ann Surg Oncol 2017; 24 (06) 1588-1595
    CrossrefPubMedGoogle Scholar
  • 67 Cormier JN, Pollock RE. Soft tissue sarcomas. CA Cancer J Clin 2004; 54 (02) 94-109
    CrossrefPubMedGoogle Scholar
  • 68 Gibbs JF, Lee RJ, Driscoll DL, McGrath BE, Mindell ER, Kraybill WG. Clinical importance of late recurrence in soft-tissue sarcomas. J Surg Oncol 2000; 73 (02) 81-86
    CrossrefPubMedGoogle Scholar
  • 69 Maretty-Nielsen K, Aggerholm-Pedersen N, Safwat A. et al. Prognostic factors for local recurrence and mortality in adult soft tissue sarcoma of the extremities and trunk wall: a cohort study of 922 consecutive patients. Acta Orthop 2014; 85 (03) 323-332
    CrossrefPubMedGoogle Scholar
  • 70 Roberts CC, Kransdorf MJ, Beaman FD. et al. ACR appropriateness criteria follow-up of malignant or aggressive musculoskeletal tumors. J Am Coll Radiol 2016; 13 (04) 389-400
    CrossrefPubMedGoogle Scholar
  • 71 Casali PG, Abecassis N, Aro HT. et al; ESMO Guidelines Committee and EURACAN. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29 (Suppl. 04) iv51-iv67
    CrossrefPubMedGoogle Scholar
  • 72 Noebauer-Huhmann IM, Weber MA, Lalam RK. et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol 2015; 19 (05) 475-482
    Article in Thieme ConnectPubMedGoogle Scholar
  • 73 Mehren MV. NCCN clinical practice guidelines in oncology (NCCN Guidelines ®). Soft tissue sarcoma. 2019 ; Accessed November 20, 2020 at: https://www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf
    PubMedGoogle Scholar
  • 74 Nöbauer-Huhmann IM. Soft tissue tumors: imaging strategy for local primary diagnostics—manifestation, pearls and pitfalls in MRI. [in German]. Radiologe 2014; 54 (08) 803-818
    CrossrefPubMedGoogle Scholar
  • 75 Yahya Zaidi M, Cardona K. Post-operative surveillance in soft tissue sarcoma: using tumor-specific recurrence patterns to direct approach. Linchuang Zhongliuxue Zazhi 2018; 7 (04) 45
    PubMedGoogle Scholar
  • 76 Tan MC, Brennan MF, Kuk D. et al. Histology-based classification predicts pattern of recurrence and improves risk stratification in primary retroperitoneal sarcoma. Ann Surg 2016; 263 (03) 593-600
    CrossrefPubMedGoogle Scholar
  • 77 Park SY, Chung HW, Chae SY, Lee JS. Comparison of MRI and PET-CT in detecting the loco-regional recurrence of soft tissue sarcomas during surveillance. Skeletal Radiol 2016; 45 (10) 1375-1384
    CrossrefPubMedGoogle Scholar
  • 78 Del Grande F, Subhawong T, Weber K, Aro M, Mugera C, Fayad LM. Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T. Radiology 2014; 271 (02) 499-511
    CrossrefPubMedGoogle Scholar
  • 79 Choi H, Varma DG, Fornage BD, Kim EE, Johnston DA. Soft-tissue sarcoma: MR imaging vs sonography for detection of local recurrence after surgery. AJR Am J Roentgenol 1991; 157 (02) 353-358
    CrossrefPubMedGoogle Scholar
  • 80 Tagliafico A, Truini M, Spina B. et al. Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound. Eur Radiol 2015; 25 (09) 2764-2770
    CrossrefPubMedGoogle Scholar
  • 81 Piperkova E, Mikhaeil M, Mousavi A. et al. Impact of PET and CT in PET/CT studies for staging and evaluating treatment response in bone and soft tissue sarcomas. Clin Nucl Med 2009; 34 (03) 146-150
    CrossrefPubMedGoogle Scholar
  • 82 Lim HJ, Johnny Ong CA, Tan JW, Ching Teo MC. Utility of positron emission tomography/computed tomography (PET/CT) imaging in the evaluation of sarcomas: a systematic review. Crit Rev Oncol Hematol 2019; 143: 1-13
    CrossrefPubMedGoogle Scholar
  • 83 Van Rijswijk CSP, Bloem JL. Follow-up imaging of soft tissue tumors. In: Vanhoenacker FM, Parizel PM, Gielen JL. eds. Imaging of Soft Tissue Tumors. 4th ed.. New York, NY: Springer International; 2017
    Google Scholar
  • 84 Dürr HR, Rauh J, Baur-Melnyk A. et al. Myxoid liposarcoma: local relapse and metastatic pattern in 43 patients. BMC Cancer 2018; 18 (01) 304
    CrossrefPubMedGoogle Scholar
  • 85 Erfanian Y, Grueneisen J, Kirchner J. et al. Integrated 18F-FDG PET/MRI compared to MRI alone for identification of local recurrences of soft tissue sarcomas: a comparison trial. Eur J Nucl Med Mol Imaging 2017; 44 (11) 1823-1831
    CrossrefPubMedGoogle Scholar
  • 86 Garner HW, Kransdorf MJ, Peterson JJ. Posttherapy imaging of musculoskeletal neoplasms. Radiol Clin North Am 2011; 49 (06) 1307-1323 , vii
    CrossrefPubMedGoogle Scholar
  • 87 Amini B, Murphy WA, Haygood TM. et al. Gadolinium-based contrast agents improve detection of recurrent soft-tissue sarcoma at MRI. Available at: https://pubs.rsna.org/doi/10.1148/rycan.2020190046. Accessed November 20, 2020
    PubMedGoogle Scholar
  • 88 Papakonstantinou O, Isaac A, Dalili D, Noebauer-Huhmann IM. T2-weighted hypointense tumors and tumor-like lesions. Semin Musculoskelet Radiol 2019; 23 (01) 58-75
    Article in Thieme ConnectPubMedGoogle Scholar
  • 89 Pezeshk P, Alian A, Chhabra A. Role of chemical shift and Dixon based techniques in musculoskeletal MR imaging. Eur J Radiol 2017; 94: 93-100
    CrossrefPubMedGoogle Scholar
  • 90 Vanel D, Shapeero LG, Tardivon A, Western A, Guinebretière JM. Dynamic contrast-enhanced MRI with subtraction of aggressive soft tissue tumors after resection. Skeletal Radiol 1998; 27 (09) 505-510
    CrossrefPubMedGoogle Scholar
  • 91 Tagliafico AS, Bignotti B, Rossi F, Valdora F, Martinoli C. Local recurrence of soft tissue sarcoma: a radiomic analysis. Radiol Oncol 2019; 53 (03) 300-306
    CrossrefPubMedGoogle Scholar
  • 92 Kransdorf MJ, Murphey MD. Imaging of Soft Tissue Tumors. 2nd ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2006: 38-79
    Google Scholar
  • 93 Richardson ML, Zink-Brody GC, Patten RM, Koh WJ, Conrad EU. MR characterization of post-irradiation soft tissue edema. Skeletal Radiol 1996; 25 (06) 537-543
    CrossrefPubMedGoogle Scholar
  • 94 Garner HW, Kransdorf MJ, Bancroft LW, Peterson JJ, Berquist TH, Murphey MD. Benign and malignant soft-tissue tumors: posttreatment MR imaging. Radiographics 2009; 29 (01) 119-134
    CrossrefPubMedGoogle Scholar
  • 95 Bloem J, Vriens D, Krol A. et al. Therapy-related imaging findings in patients with sarcoma. Semin Musculoskelet Radiol 2020; 24 (06) 676-691
    Article in Thieme ConnectPubMedGoogle Scholar
  • 96 Vanel D, Shapeero LG, De Baere T. et al. MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations. Radiology 1994; 190 (01) 263-268
    CrossrefPubMedGoogle Scholar
  • 97 Biondetti PR, Ehman RL. Soft-tissue sarcomas: use of textural patterns in skeletal muscle as a diagnostic feature in postoperative MR imaging. Radiology 1992; 183 (03) 845-848
    CrossrefPubMedGoogle Scholar
  • 98 Vanel D, Lacombe MJ, Couanet D, Kalifa C, Spielmann M, Genin J. Musculoskeletal tumors: follow-up with MR imaging after treatment with surgery and radiation therapy. Radiology 1987; 164 (01) 243-245
    CrossrefPubMedGoogle Scholar
  • 99 Hwang S, Lefkowitz R, Landa J. et al. Local changes in bone marrow at MRI after treatment of extremity soft tissue sarcoma. Skeletal Radiol 2009; 38 (01) 11-19
    CrossrefPubMedGoogle Scholar
  • 100 Stevens SK, Moore SG, Kaplan ID. Early and late bone-marrow changes after irradiation: MR evaluation. AJR Am J Roentgenol 1990; 154 (04) 745-750
    CrossrefPubMedGoogle Scholar
  • 101 Blomlie V, Rofstad EK, Skjønsberg A, Tverå K, Lien HH. Female pelvic bone marrow: serial MR imaging before, during, and after radiation therapy. Radiology 1995; 194 (02) 537-543
    CrossrefPubMedGoogle Scholar
  • 102 Casamassima F, Ruggiero C, Caramella D, Tinacci E, Villari N, Ruggiero M. Hematopoietic bone marrow recovery after radiation therapy: MRI evaluation. Blood 1989; 73 (06) 1677-1681
    CrossrefPubMedGoogle Scholar
  • 103 Peat BG, Bell RS, Davis A. et al. Wound-healing complications after soft-tissue sarcoma surgery. Plast Reconstr Surg 1994; 93 (05) 980-987
    CrossrefPubMedGoogle Scholar
  • 104 Baldini EH, Lapidus MR, Wang Q. et al. Predictors for major wound complications following preoperative radiotherapy and surgery for soft-tissue sarcoma of the extremities and trunk: importance of tumor proximity to skin surface. Ann Surg Oncol 2013; 20 (05) 1494-1499
    CrossrefPubMedGoogle Scholar
  • 105 Davies AM, Vanel D. Follow-up of musculoskeletal tumors. I. Local recurrence. Eur Radiol 1998; 8 (05) 791-799
    CrossrefPubMedGoogle Scholar
  • 106 Poon-Chue A, Menendez L, Gerstner MM, Colletti P, Terk M. MRI evaluation of post-operative seromas in extremity soft tissue sarcomas. Skeletal Radiol 1999; 28 (05) 279-282
    CrossrefPubMedGoogle Scholar
  • 107 Liu PT, Leslie KO, Beauchamp CP, Cherian SF. Chronic expanding hematoma of the thigh simulating neoplasm on gadolinium-enhanced MRI. Skeletal Radiol 2006; 35 (04) 254-257
    CrossrefPubMedGoogle Scholar
  • 108 Aoki T, Nakata H, Watanabe H. et al. The radiological findings in chronic expanding hematoma. Skeletal Radiol 1999; 28 (07) 396-401
    CrossrefPubMedGoogle Scholar
  • 109 Oka K, Yakushiji T, Sato H. et al. Ability of diffusion-weighted imaging for the differential diagnosis between chronic expanding hematomas and malignant soft tissue tumors. J Magn Reson Imaging 2008; 28 (05) 1195-1200
    CrossrefPubMedGoogle Scholar
  • 110 Reid JD, Kommareddi S, Lankerani M, Park MC. Chronic expanding hematomas. A clinicopathologic entity. JAMA 1980; 244 (21) 2441-2442
    CrossrefPubMedGoogle Scholar
  • 111 Nagano S, Yokouchi M, Setoguchi T. et al. Analysis of surgical site infection after musculoskeletal tumor surgery: risk assessment using a new scoring system. Sarcoma 2014; 2014: 645496
    CrossrefPubMedGoogle Scholar
  • 112 Soldatos T, Durand DJ, Subhawong TK, Carrino JA, Chhabra A. Magnetic resonance imaging of musculoskeletal infections: systematic diagnostic assessment and key points. Acad Radiol 2012; 19 (11) 1434-1443
    CrossrefPubMedGoogle Scholar
  • 113 Lalam RK, Cassar-Pullicino VN, Tins BJ. Magnetic resonance imaging of appendicular musculoskeletal infection. Top Magn Reson Imaging 2007; 18 (03) 177-191
    CrossrefPubMedGoogle Scholar
  • 114 Harish S, Chiavaras MM, Kotnis N, Rebello R. MR imaging of skeletal soft tissue infection: utility of diffusion-weighted imaging in detecting abscess formation. Skeletal Radiol 2011; 40 (03) 285-294
    CrossrefPubMedGoogle Scholar
  • 115 Bluemke DA, Fishman EK, Scott Jr WW. Skeletal complications of radiation therapy. Radiographics 1994; 14 (01) 111-121
    CrossrefPubMedGoogle Scholar
  • 116 Moore LF, Kransdorf MJ, Buskirk SJ, O'Connor MI, Menke DM. Radiation-induced pseudotumor following therapy for soft tissue sarcoma. Skeletal Radiol 2009; 38 (06) 579-584
    CrossrefPubMedGoogle Scholar
  • 117 O'Connell JX, English JC, Beauchamp CP, Connell DG. Intramuscular hypertrophic scar: an unusual complication following soft tissue sarcoma resection. Skeletal Radiol 1995; 24 (04) 305-307
    CrossrefPubMedGoogle Scholar
  • 118 Radtke C, Vogt PM. Nerve injuries and posttraumatic therapy [in German]. Unfallchirurg 2014; 117 (06) 539-555 ; quiz 556
    CrossrefPubMedGoogle Scholar
  • 119 Wolford LM, Stevao EL. Considerations in nerve repair. Proc Bayl Univ Med Cent 2003; 16 (02) 152-156
    CrossrefPubMedGoogle Scholar
  • 120 Kerimoglu U, Canyigit M. Paradoxic hypertrophy of the sciatic nerve in adult patients after above-knee amputation. Acta Radiol 2007; 48 (09) 1028-1031
    CrossrefPubMedGoogle Scholar
  • 121 Grieser T, Nöbauer-Huhmann IM. Postoperative and posttherapeutic changes after primary bone tumors : what's important for radiologists?. [in German]. Radiologe 2017; 57 (11) 938-957
    CrossrefPubMedGoogle Scholar
  • 122 Waters B, Panicek DM, Lefkowitz RA. et al. Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. AJR Am J Roentgenol 2007; 188 (02) W193-W198
    CrossrefPubMedGoogle Scholar
  • 123 Ezuddin NS, Pretell-Mazzini J, Yechieli RL, Kerr DA, Wilky BA, Subhawong TK. Local recurrence of soft-tissue sarcoma: issues in imaging surveillance strategy. Skeletal Radiol 2018; 47 (12) 1595-1606
    CrossrefPubMedGoogle Scholar
  • 124 Alpert JS, Boland P, Hameed M, Panicek DM. Undifferentiated pleomorphic sarcoma: indolent, tail-like recurrence of a high-grade tumor. Skeletal Radiol 2018; 47 (01) 141-144
    CrossrefPubMedGoogle Scholar
  • 125 Kotnis NA, Grimer RJ, Davies AM, James SL. Magnetic resonance imaging appearances following hindquarter amputation for pelvic musculoskeletal malignancy. Skeletal Radiol 2009; 38 (12) 1137-1146
    CrossrefPubMedGoogle Scholar
  • 126 Kransdorf MJ, Murphey MD. Soft tissue tumors: post-treatment imaging. Radiol Clin North Am 2006; 44 (03) 463-472
    CrossrefPubMedGoogle Scholar
  • 127 Panicek DM, Schwartz LH, Heelan RT, Caravelli JF. Non-neoplastic causes of high signal intensity at T2-weighted MR imaging after treatment for musculoskeletal neoplasm. Skeletal Radiol 1995; 24 (03) 185-190
    CrossrefPubMedGoogle Scholar
  • 128 Shapeero LG, Vanel D, Verstraete KL, Bloem JL. Fast magnetic resonance imaging with contrast for soft tissue sarcoma viability. Clin Orthop Relat Res 2002; (397) 212-227
    CrossrefPubMedGoogle Scholar
  • 129 Baur A, Huber A, Arbogast S. et al. Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans. Eur Radiol 2001; 11 (05) 828-833
    CrossrefPubMedGoogle Scholar
  • 130 Murphey MD, Arcara LK, Fanburg-Smith J. From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 2005; 25 (05) 1371-1395
    CrossrefPubMedGoogle Scholar
  • 131 Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N. Primary dedifferentiated liposarcoma of the retroperitoneum. Prognostic significance of computed tomography and magnetic resonance imaging features. J Comput Assist Tomogr 2003; 27 (05) 799-804
    CrossrefPubMedGoogle Scholar
  • 132 Patel SR. Radiation-induced sarcoma. Curr Treat Options Oncol 2000; 1 (03) 258-261
    CrossrefPubMedGoogle Scholar
  • 133 Lagrange JL, Ramaioli A, Chateau MC. et al; Radiation Therapist and Pathologist Groups of the Fédération Nationale des Centres de Lutte Contre le Cancer. Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiology 2000; 216 (01) 197-205
    CrossrefPubMedGoogle Scholar
  • 134 Sheppard DG, Libshitz HI. Post-radiation sarcomas: a review of the clinical and imaging features in 63 cases. Clin Radiol 2001; 56 (01) 22-29
    CrossrefPubMedGoogle Scholar
  • 135 Kim JH, Chu FC, Woodard HQ, Melamed MR, Huvos A, Cantin J. Radiation-induced soft-tissue and bone sarcoma. Radiology 1978; 129 (02) 501-508
    CrossrefPubMedGoogle Scholar
  • 136 Laskin WB, Silverman TA, Enzinger FM. Postradiation soft tissue sarcomas. An analysis of 53 cases. Cancer 1988; 62 (11) 2330-2340
    CrossrefPubMedGoogle Scholar