title: ACR Appropriateness Criteria Follow-Up of Malignant or Aggressive Musculoskeletal Tumors.
abstract: Appropriate imaging modalities for the follow-up of malignant or aggressive musculoskeletal tumors include radiography, MRI, CT, (18)F-2-fluoro-2-deoxy-D-glucose PET/CT, (99m)Tc bone scan, and ultrasound. Clinical scenarios reviewed include evaluation for metastatic disease to the lung in low- and high-risk patients, for osseous metastatic disease in asymptomatic and symptomatic patients, for local recurrence of osseous tumors with and without significant hardware present, and for local recurrence of soft tissue tumors. The timing for follow-up of pulmonary metastasis surveillance is also reviewed. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: Mayo Clinic, Phoenix, Arizona. Electronic address: roberts.catherine@mayo.edu.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Roberts
authors.affiliation: Mayo Clinic, Phoenix, Arizona.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Kransdorf
authors.affiliation: University of Kentucky, Lexington, Kentucky.
authors.forename: Francesca D
authors.initials: FD
authors.lastname: Beaman
authors.affiliation: New York University Center for Musculoskeletal Care, New York, New York.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Adler
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Behrang
authors.initials: B
authors.lastname: Amini
authors.affiliation: Warwick Valley Orthopedic Surgery, Warwick, New York, American Academy of Orthopaedic Surgeons.
authors.forename: Marc
authors.initials: M
authors.lastname: Appel
authors.affiliation: Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Bernard
authors.affiliation: Bone, Spine and Hand Surgery, Chartered, Brick, New Jersey, American Academy of Orthopaedic Surgeons.
authors.forename: Ian Blair
authors.initials: IB
authors.lastname: Fries
authors.affiliation: Mount Sinai School of Medicine, New York, New York.
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Germano
authors.affiliation: Medical College of Georgia, Augusta, Georgia.
authors.forename: Bennett S
authors.initials: BS
authors.lastname: Greenspan
authors.affiliation: University of California Los Angeles Medical Center, Los Angeles, California.
authors.forename: Langston T
authors.initials: LT
authors.lastname: Holly
authors.affiliation: Oregon Health & Science University, Portland, Oregon.
authors.forename: Charlotte D
authors.initials: CD
authors.lastname: Kubicky
authors.affiliation: University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Simon Shek-Man
authors.initials: SS
authors.lastname: Lo
authors.affiliation: Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Mosher
authors.affiliation: University Hospital Case Medical Center, Cleveland, Ohio.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Sloan
authors.affiliation: University of Wisconsin Hospital, Madison, Wisconsin.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tuite
authors.affiliation: Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Walker
authors.affiliation: Tufts Medical Center, Boston, Massachusetts.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ward
authors.affiliation: Mayo Clinic, Jacksonville, Florida.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Wessell
authors.affiliation: Brigham & Women's Hospital, Boston, Massachusetts.
authors.forename: Barbara N
authors.initials: BN
authors.lastname: Weissman
mesh_terms: D000359:Aftercare / Q000592:standards*; D003952:Diagnostic Imaging / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000592:standards; D011379:Prognosis; D011871:Radiology / Q000592:standards*; D012955:Societies, Medical / Q000592:standards; D016896:Treatment Outcome; D014481:United States
keywords: Appropriateness Criteria; aggressive; follow-up; imaging; malignant; musculoskeletal tumors