What is the role of imaging studies in the diagnosis of soft tissue angiosarcoma (AS)?

Updated: Sep 04, 2018
  • Author: Maria Belén Carsi, MD, PhD, FRCS; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

The choice of imaging studies for angiosarcoma varies somewhat, depending on whether the lesion is located in soft tissue, bone, or skin.

Soft tissue angiosarcoma

For angiosarcoma of the extremities, retroperitoneum, or abdominal wall, magnetic resonance imaging (MRI) provides more accurate delineation of the extent of local disease than computed tomography (CT). MRI provides sagittal and coronal views and better distinction between bone, vascular structures, and tumor than CT scanning. MRI or plain radiographs should address the possibility of bone invasion by the tumor.

MRI is the imaging modality of choice to evaluate the tumor response to preoperative radiation or chemotherapy. It can detect changes in tumor size and in the relationship of the mass to adjacent vital structures and can identify areas of intratumoral necrosis or hemorrhage, especially with the use of static or dynamic gadolinium-enhanced imaging techniques.

Chest CT scan is useful in the detection of lung, pleural, and mediastinal metastasis. Searches for bone and brain metastasis rarely are indicated unless the patient has clinical manifestations suggesting involvement of these organs.


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