MRI Area of Interest Without IV Contrast There is insufficient literature to support the routine use of MRI without IV contrast as the initial examination for a soft tissue mass. The inherent limitations of this modality, most notably in the identification of mineralization, limit its use in isolation. CT Area of Interest With IV Contrast CT with IV contrast does not typically play a role in the initial evaluation of a superficial soft tissue mass. Soft Tissue Masses CT Area of Interest Without and With IV Contrast CT does not typically play a role in the initial evaluation of a superficial soft tissue mass. CT Area of Interest Without IV Contrast CT does not typically play a role in the initial evaluation of a superficial soft tissue mass. FDG-PET/CT Area of Interest There is insufficient literature to support the routine use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT for the initial evaluation of a soft tissue mass. Image-Guided Biopsy Area of Interest The literature does not support the use of image-guided biopsy as the initial examination for a soft tissue mass. At least 20% to 25% of soft tissue masses can demonstrate features that allow for confident diagnosis based on MRI alone [23], many of which are benign and thus would not warrant biopsy. Therefore, diagnostic imaging that includes comprehensive characterization of the mass should routinely be performed before biopsy. In fact, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for Soft Tissue Sarcoma state that biopsy should be performed only after adequate imaging [24]. Image-Guided Fine Needle Aspiration Area of Interest The literature does not support the use of image-guided fine needle aspiration as the initial examination for a soft tissue mass. At least 20% to 25% of soft tissue masses can demonstrate features that allow for confident diagnosis based on MRI alone [23], many of which are benign and thus would not warrant fine needle aspiration.
Soft Tissue Masses. MRI Area of Interest Without IV Contrast There is insufficient literature to support the routine use of MRI without IV contrast as the initial examination for a soft tissue mass. The inherent limitations of this modality, most notably in the identification of mineralization, limit its use in isolation. CT Area of Interest With IV Contrast CT with IV contrast does not typically play a role in the initial evaluation of a superficial soft tissue mass. Soft Tissue Masses CT Area of Interest Without and With IV Contrast CT does not typically play a role in the initial evaluation of a superficial soft tissue mass. CT Area of Interest Without IV Contrast CT does not typically play a role in the initial evaluation of a superficial soft tissue mass. FDG-PET/CT Area of Interest There is insufficient literature to support the routine use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT for the initial evaluation of a soft tissue mass. Image-Guided Biopsy Area of Interest The literature does not support the use of image-guided biopsy as the initial examination for a soft tissue mass. At least 20% to 25% of soft tissue masses can demonstrate features that allow for confident diagnosis based on MRI alone [23], many of which are benign and thus would not warrant biopsy. Therefore, diagnostic imaging that includes comprehensive characterization of the mass should routinely be performed before biopsy. In fact, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for Soft Tissue Sarcoma state that biopsy should be performed only after adequate imaging [24]. Image-Guided Fine Needle Aspiration Area of Interest The literature does not support the use of image-guided fine needle aspiration as the initial examination for a soft tissue mass. At least 20% to 25% of soft tissue masses can demonstrate features that allow for confident diagnosis based on MRI alone [23], many of which are benign and thus would not warrant fine needle aspiration.