Metastatic disease decreases survival, with pulmonary metastases as the primary cause of death in patients with osteosarcoma [6,7]. Metastasectomy improves survival, and thermal ablation and radiation therapy are emerging as promising alternative treatment options [8-10]. Therefore, evaluation for pulmonary metastases is an essential part of primary musculoskeletal tumor initial staging. CT Chest With IV Contrast There is no relevant literature regarding the specific use of CT chest with intravenous (IV) contrast in the evaluation of pulmonary metastasis from malignant or aggressive primary musculoskeletal tumors. However, IV contrast may lead to equivocal assessment of mineralization, which can be a useful morphologic feature to distinguish benign versus malignant pulmonary nodules. Therefore, CT chest with IV contrast is not generally useful as the sole imaging technique, and there is felt to be little additional benefit in the CT assessment of pulmonary nodules without and with IV contrast compared with CT chest without IV contrast in this setting. CT Chest Without and With IV Contrast There is no relevant literature regarding the specific use of CT chest without and with IV contrast in the evaluation of pulmonary metastasis from malignant or aggressive primary musculoskeletal tumors. However, IV contrast may lead to equivocal assessment of mineralization, which can be a useful morphologic feature to distinguish benign versus malignant pulmonary nodules. Therefore, CT chest with IV contrast is not generally useful as the sole imaging technique, and there is felt to be little additional benefit in the CT assessment of pulmonary nodules without and with IV contrast compared with CT chest without IV contrast in this setting. CT Chest Without IV Contrast CT chest is the most sensitive imaging modality for identifying pulmonary nodules compared with radiography, fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT, or FDG-PET/MRI.
Malignant or Aggressive Primary Musculoskeletal Tumor Staging And Surveillance PCAs. Metastatic disease decreases survival, with pulmonary metastases as the primary cause of death in patients with osteosarcoma [6,7]. Metastasectomy improves survival, and thermal ablation and radiation therapy are emerging as promising alternative treatment options [8-10]. Therefore, evaluation for pulmonary metastases is an essential part of primary musculoskeletal tumor initial staging. CT Chest With IV Contrast There is no relevant literature regarding the specific use of CT chest with intravenous (IV) contrast in the evaluation of pulmonary metastasis from malignant or aggressive primary musculoskeletal tumors. However, IV contrast may lead to equivocal assessment of mineralization, which can be a useful morphologic feature to distinguish benign versus malignant pulmonary nodules. Therefore, CT chest with IV contrast is not generally useful as the sole imaging technique, and there is felt to be little additional benefit in the CT assessment of pulmonary nodules without and with IV contrast compared with CT chest without IV contrast in this setting. CT Chest Without and With IV Contrast There is no relevant literature regarding the specific use of CT chest without and with IV contrast in the evaluation of pulmonary metastasis from malignant or aggressive primary musculoskeletal tumors. However, IV contrast may lead to equivocal assessment of mineralization, which can be a useful morphologic feature to distinguish benign versus malignant pulmonary nodules. Therefore, CT chest with IV contrast is not generally useful as the sole imaging technique, and there is felt to be little additional benefit in the CT assessment of pulmonary nodules without and with IV contrast compared with CT chest without IV contrast in this setting. CT Chest Without IV Contrast CT chest is the most sensitive imaging modality for identifying pulmonary nodules compared with radiography, fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT, or FDG-PET/MRI.