Follow-Up Imaging of Soft Tissue Tumors
The purpose of this chapter is threefold. First objective is to summarize therapy-induced changes in normal tissue that can be differentiated from disease activity. Second is to identify which imaging parameters can be used now and in the near future to monitor the response to therapy. Finally the role of imaging in detecting recurrent disease is discussed from a clinical perspective. The aim of therapy in patients with soft tissue sarcoma is to irradicate (curative) or modify biologic behavior (palliative) of sarcoma while minimizing damage of normal tissues. This is done by local (surgery, isolated limb perfusion, and radiation) or systemic (neoadjuvant and adjuvant chemotherapy) therapy.
Prognosis of patients with soft tissue sarcoma is mainly influenced by local recurrence and development of distant metastasis and thus also by response to treatment. Approximately one-third of all patients with soft tissue sarcomas will develop local recurrence or distant metastatic disease, with the highest risk in the first few years after treatment; however, late recurrences after 5 years do occur. The overall survival mainly depends on the development of metastatic disease.
The patterns of recurrence vary with the anatomic site of the primary tumor. Patients with extremity and superficial trunk primaries have a higher predilection for metastases and a lower probability of locoregional recurrences. In contrast, patients with retroperitoneal or head and neck tumors have a higher tendency toward locoregional recurrences compared to metastases. In this chapter we’ll address the use of imaging in patients treated for soft tissue sarcoma.
KeywordsApparent Diffusion Coefficient Standardize Uptake Value Soft Tissue Sarcoma Locoregional Recurrence Soft Tissue Tumor
The input of Dr. Yvonne van Schrage (surgery), Dr. Stijn Krol (radiotherapy), and Prof. Judith Bovee (pathology) is greatly appreciated.
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