Differentiation of malignant from benign soft tissue tumors is challenging with imaging
alone, including that by magnetic resonance imaging and computed tomography. However, the accuracy
of this differentiation has increased owing to the development of novel imaging technology.
Detailed patient history and physical examination remain essential for differentiation between benign
and malignant soft tissue tumors. Moreover, measurement only of tumor size based on Response
Evaluation Criteria In Solid Tumors criteria is insufficient for the evaluation of response to
chemotherapy or radiotherapy. Change in metabolic activity measured by 18F-fluorodeoxyglucose
positron emission tomography or dynamic contrast enhanced-derived quantitative endpoints can
more accurately evaluate treatment response compared to change in tumor size. Magnetic resonance
imaging can accurately evaluate essential factors in surgical planning such as vascular or
bone invasion and “tail sign”. Thus, imaging plays a critical role in the diagnosis and treatment of
soft tissue tumors.
Keywords: Imaging, soft tissue tumor, sarcoma, CT, MRI, PET.
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