Radiologic diagnosis of malignant soft-tissue tumors of the extremities

In malignant soft-tissue tumors of the extremities the radiologist is asked to define size and extent of the lesion and it's relationship to adjacent structures. The assessment of the nature of the lesion is of utmost importance, however, the contribution of the different imaging modalities varies considerably. In a review article the current roles of conventional radiography, xeroradiography, real-time ultrasonography, computed tomography and arteriography in the diagnostic workup of malignant soft-tissue tumors of the extremities are discussed. The statements made are based upon own comparative studies as well as on a review of the literature. In the assessment of the nature of a soft-tissue mass the contribution of all radiologic imaging methods is rather limited, although arteriography may add valuable information if performed complementary to CT. Real-time ultrasonography is well suited to define size, location and extent of peripheral soft-tissue masses. It is therefore recommended as the first imaging method and for follow-up studies. Equivocal findings by real-time sonography and new cases for treatment planning must be confirmed by computed tomography which proved to be the most reliable and the best reproducible imaging method for soft-tissue tumors of the extremities. (orig.)