Noebauer-Huhmann Iris-Melanie, Vilanova Joan C, Papakonstantinou Olympia, Weber Marc-André, Lalam Radhesh K, Nikodinovska Violeta Vasilevska, Sanal Hatice T, Lecouvet Frédéric E, Navas Ana, Martel-Villagrán José, de Rooy Jacky W J, Fritz Jan, Verstraete Koenraad, Grieser Thomas, Szomolanyi Pavol, Chaudhary Snehansh, Sconfienza Luca Maria, Tagliafico Alberto S, Afonso P Diana, Albtoush Omar M, Aringhieri Giacomo, Arkun Remide, Aström Gunnar, Bazzocchi Alberto, Botchu Rajesh, Breitenseher Martin, Dalili Danoob, Davies Mark, de Jonge Milko C, Mete Berna D, Gielen Jan L M A, Hide Geoff, Isaac Amanda, Ivanoski Slavcho, Mansour Ramy M, Mccarthy Catherine, Muntaner-Gimbernat Lorenzo, O'Donnell Paul, Örgüç Şebnem, Rennie Winston J, Resano Santiago, Robinson Philip, Ter Horst Simone A J, van Langevelde Kirsten, Wörtler Klaus, Koelz Marita, Panotopoulos Joannis, Windhager Reinhard, Fueger Barbara J, Schmid Maximilian, Vanhoenacker Filip M
Department of Biomedical Imaging and Image Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
Department of Radiology, Clínica Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain.
Eur Radiol. 2025 Jun;35(6):3324-3335. doi: 10.1007/s00330-024-11242-0. Epub 2024 Dec 18.
An update of the first European Society of Musculoskeletal Radiology (ESSR) consensus on soft tissue tumor imaging in 2015 became necessary due to technical advancements, further insights into specific entities, and the revised WHO classification (2020) and AJCC staging system (2017). The third part of the revised guidelines covers algorithms and techniques beyond initial imaging: (1) Imaging after neoadjuvant therapy in soft tissue sarcoma, (2) sarcoma surveillance, and (3) special aspects, including surveillance of non-malignant entities and the role of interventional radiology.
A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements that had undergone interdisciplinary revision were scored online by level of agreement (0 to 10) during two iterative rounds that could result in either 'group consensus,' 'group agreement,' or 'lack of agreement.'
The three sections contain 47 statements with comments. Group consensus was reached in 91.5%, group agreement in 6.4%, lack of agreement in 2.1%. In sarcoma, imaging immediately after neoadjuvant therapy is pivotal for determining the therapy effects and for resection-planning; surveillance should include imaging at fixed grade- and type-dependent intervals. In general, MRI is the method of choice for loco-regional surveillance of soft tissue sarcomas, and chest CT to assess metastatic disease. Interventional radiology has a role, especially in oligometastatic disease, palliative tumor control and local recurrences.
Strategies for standardized soft tissue tumor imaging regarding therapy control, surveillance, and useful interventional procedures are provided.
Question An ESSR consensus update on soft tissue tumor imaging regarding surveillance became necessary due to technical advancements, further entity-specific insights, and revised WHO- and AJCC-classifications. Findings Imaging immediately after neoadjuvant therapy in soft tissue sarcoma is pivotal. Post-therapeutic surveillance should include imaging at regular intervals, stratified for tumor grade and type. Clinical relevance The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability, both in individual patients and in future studies on individualized strategies.
由于技术进步、对特定实体有了更深入的认识以及世界卫生组织修订分类（2020年）和美国癌症联合委员会分期系统（2017年），有必要对欧洲肌肉骨骼放射学会（ESSR）2015年关于软组织肿瘤成像的第一份共识进行更新。修订指南的第三部分涵盖了初始成像之外的算法和技术：（1）软组织肉瘤新辅助治疗后的成像，（2）肉瘤监测，以及（3）特殊方面，包括非恶性实体的监测和介入放射学的作用。
采用基于同行评审文献的经验证的德尔菲法，在来自12个欧洲国家的46名专业肌肉骨骼放射科医生组成的小组中达成共识。经过跨学科修订的陈述在两轮迭代中通过在线协议水平（0至10）进行评分，可能达成“小组共识”“小组一致意见”或“未达成一致意见”。
这三个部分包含47条带注释的陈述。达成小组共识的占91.5%，达成小组一致意见的占6.4%，未达成一致意见的占2.1%。在肉瘤方面，新辅助治疗后立即成像对于确定治疗效果和制定切除计划至关重要；监测应包括按固定的与分级和类型相关的间隔进行成像。一般来说，MRI是软组织肉瘤局部区域监测的首选方法，胸部CT用于评估转移情况。介入放射学有其作用，特别是在寡转移疾病、姑息性肿瘤控制和局部复发方面。
提供了关于治疗控制、监测和有用介入程序的标准化软组织肿瘤成像策略。
问题 由于技术进步、对特定实体有了更深入的认识以及世界卫生组织和美国癌症联合委员会分类的修订，有必要对ESSR关于软组织肿瘤成像监测的共识进行更新。研究结果 软组织肉瘤新辅助治疗后立即成像至关重要。治疗后监测应包括定期成像，根据肿瘤分级和类型分层。临床意义 更新后的ESSR软组织肿瘤成像指南旨在为标准化成像提供最佳实践专家共识，支持放射科医生进行决策，并提高个体患者以及未来个体化策略研究中的检查可比性。
