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Diagnostic Imaging in Bone and Soft-Tissue Sarcomas: Practice, Education, and...
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Diagnostic Imaging in Bone and Soft-Tissue Sarcomas: Practice, Education, and Innovation—2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 878

Special Issue Editor

Dr. Paolo Spinnato

E-Mail Website1 Website2
Guest Editor
Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Interests: fracture; imaging; computed tomography; osteoporosis; musculoskeletal imaging; spine; bone; ultrasound; magnetic resonance imaging; multiple myeloma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal sarcomas are rare tumors accounting for only 1% of all adult malignancies. Soft-tissue sarcomas account for about 80% of them, while bone sarcomas for the remaining 20%.

Imaging has a key role at each phase of care: diagnosis, image-guided biopsy, baseline assessment (surgical planning and prognosis prediction), treatment response evaluation, and follow-up controls (including recurrence assessment).

Several years ago, radiological studies were mainly used to detect the dimensions and location of lesions. Nowadays, numerous imaging features are extracted (qualitatively or quantitatively) with different clinical aims, with the goal of more personalized care.

In this Special Issue, we will provide high-quality articles on musculoskeletal oncology with educational aims helping in everyday clinical practice, as well as research on the latest imaging trends.

Dr. Paolo Spinnato
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • soft-tissue sarcomas
  • bone sarcomas
  • imaging
  • MRI
  • CT

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Published Papers (2 papers)

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Research

10 pages, 1948 KiB  
Article
The Use of Positron-Emission Tomography–Magnetic Resonance Imaging to Improve the Local Staging of Disease in Myxofibrosarcoma: A Feasibility Study
by Corey D. Chan, Marcus J. Brookes, Tamir Ali, Elizabeth Howell, Petra Dildey, Michael Firbank, Rachel Pearson, Philip Sloan, Simon Lowes, Raj Sinha, John Tuckett, Maniram Ragbir, Thomas Beckingsale, Geoff Hide, Craig Gerrand, Kenneth S. Rankin and George S. Petrides
Diagnostics 2025, 15(8), 1039; https://doi.org/10.3390/diagnostics15081039 - 19 Apr 2025
Viewed by 380
Abstract
Background/Objectives: Myxofibrosarcomas (MFSs) are aggressive soft-tissue sarcomas (STSs) that often arise in the upper and lower limbs. MFSs are a highly infiltrative sarcoma subtype with a high positive margin rate and poor clinical outcomes. Their management involves multidisciplinary team (MDT) input, with [...] Read more.
Background/Objectives: Myxofibrosarcomas (MFSs) are aggressive soft-tissue sarcomas (STSs) that often arise in the upper and lower limbs. MFSs are a highly infiltrative sarcoma subtype with a high positive margin rate and poor clinical outcomes. Their management involves multidisciplinary team (MDT) input, with the mainstay of treatment being a wide surgical resection to remove the whole tumour, but this can be challenging due to the infiltrative nature of MFSs through fascial planes. Appropriate pre-operative imaging is therefore essential for surgical planning. Currently, MRI imaging is the modality of choice to assess the soft-tissue extent of MFSs; however, it does not always reliably predict tumour extent, especially when an MRI shows high-signal curvilinear projections, known as “tails”, which often represent tumour extension and increase the risk of positive margins and local recurrence. Methods: This feasibility study therefore aimed to investigate whether the addition of an FDG PET-MRI and DWI MRI is superior for the local staging of MFSs compared to a standard MRI, and to assess its practicality for clinical use. Results: Of the eight patients recruited, six completed the required scans, proceeded to surgery, and were included in the data analyses. Five of the six patients had close (<2 mm) or positive margins requiring re-excision. Conclusions: Our results show that combining an FDG-PET and DWI MRI may offer a more accurate local staging of MFSs than a conventional MRI; however, a larger prospective trial is needed to further investigate this pilot data. Nevertheless, this novel feasibly study demonstrates the potential use of PET-MRI and DWI for improving pre-operative planning prior to the surgical resection of MFSs. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Bone and Soft-Tissue Sarcomas: Practice, Education, and Innovation—2nd Edition)
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Article
Clear Cell Sarcoma of Soft Tissues: Radiological Analysis of 14 Patients—MRI Findings Related to Metastatic Disease
by Paola Di Masi, Marco Colangeli, Mario Simonetti, Giuseppe Bianchi, Alberto Righi, Gabriele Bilancia, Emanuela Palmerini, Amandine Crombé and Paolo Spinnato
Diagnostics 2025, 15(8), 1027; https://doi.org/10.3390/diagnostics15081027 - 17 Apr 2025
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Abstract
Background/Objectives: Clear cell sarcoma (CCS) is a very uncommon, aggressive soft-tissue sarcoma (STS) with a dismal prognosis. In the current literature, there are very limited data focused on the radiological features of CCS. Our study’s objective was to describe CCS pre-treatment’s peculiar imaging [...] Read more.
Background/Objectives: Clear cell sarcoma (CCS) is a very uncommon, aggressive soft-tissue sarcoma (STS) with a dismal prognosis. In the current literature, there are very limited data focused on the radiological features of CCS. Our study’s objective was to describe CCS pre-treatment’s peculiar imaging characteristics (MRI above all) and to assess if some radiologic features may predict patients’ outcomes with regard to the occurrence of distant metastases. Methods: Our single-center experience includes all the patients with a histological diagnosis of CCS and available radiological and clinical data: 14 patients (8M, 6F, mean age 39.4 years old) were included. The available pre-treatment MRI or contrast-enhanced computed tomography (CECT) studies were examined using an analytical grid that incorporated characteristics from the most recent STS research. The occurrence of metastatic disease was matched with radiological features from baseline imaging studies. Results: MRI was available in 13 patients and CECT in 1 patient. The mean longest diameter (LD) was 50.5 mm ± 29.2. In 10 cases (71.4%), the tumor was deeply seated. MRI revealed a slightly high signal intensity (SI) on T1-WI and a high SI on T2-WI in every subject. At baseline, metastases were already present in 5/14 (35.7%) patients, 3 more developed metastases during the following 5 years (8/14, 57.1%), and 2 additional developed late-onset metastasis after more than 5 years from the diagnosis (total of 10/14 metastatic patients 71.4%). LD and metastasis at diagnosis were significantly correlated (Pearson correlation = 72%, p-value = 0.004). A pre-treatment LD > 4 cm was significantly associated with the development of distant metastases within 5 years from diagnosis and in subsequent follow-up (p = 0.0003). LD > 4 cm represents an increase in risk of metastatic disease within 5 years and during the course of follow-up (OR = 195.00, 95%CI: 3.36–11285.55, p = 0.01). The presence of MRI signs of macroscopic necrosis represented an increase in risk of metastatic disease within 5 years (OR = 15.00, 95%CI: 1.03–218.31—p = 0.04). Conclusions: The identification of MRI features of aggressive biology is a key element for an early referral to sarcoma centers. In our study, a LD > 4 cm and the presence of MRI signs of macroscopic necrosis at the baseline images resulted in being a predictor of metastatic disease. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Bone and Soft-Tissue Sarcomas: Practice, Education, and Innovation—2nd Edition)
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