Bone Cancer

Metastasis suspected

Painful Bone lesion with an abnormal x-ray

• CT Chest, Abdomen and Pelvis; Bone Scan

Chondrosarcoma

Surveillance Imaging

• CT or MRI of affected site every six moths for 2 years
• CT chest every 3-6 months for five years, then annually for ten years

Chordoma

Work Up

• CT or MRI of primary site
• MRI of spinal axis
• CT of Chest, Abdomen, and Pelvis
• PET and or Bone Scan if needed to clarify clinical status

Surveillance (after therapy)

• CT or MRI of surgical site
• CT chest every six months for five years, then annually
• CT or MRI of Abdomen annually

Ewing Sarcoma

Initial Workup

• MRI or CT of Primary site
• PET/CT or Bone Scan
• CT Chest
• MRI spine and pelvis

Restaging

• CT Chest
• MRI or CT of affected site
• PET/CT or Bone Scan
• Repeat of any prior abnormal studies

Surveillance

• Local imaging every 3 months for 2 yrs, then every 6 months for 3, then annually
• Chest imaging on same schedule

Giant Cell Tumor of Bone

Work Up

• CT or MRI of primary site
• CT Chest
• Bone Scan

Surveillance

• CT or MRI of Surgical Site if clinically indicated
• CT Chest twice yearly for two years then annually

Osteosarcoma

Initial Workup

• MRI or CT of Primary site
• PET/CT or Bone Scan
• CT Chest
• CT or MRI of any suspected skeletal metastatic sites

Restaging

• CT Chest
• MRI or CT of affected site
• PET/CT or Bone Scan
• Repeat of any prior abnormal studies

Surveillance

• Local imaging every 3 months for 2 yrs, then every 4 months for 1, then every 6 month for years 4 and 5, then annually
• Chest imaging on same schedule
• PET/CT or Bone scan if clinically indicated

References

• NCCN Guidelines Version 1.2015 Bone Cancer Accessed 5/12/2015
• NCCN Guidelines Version 2.2012 Bone Cancer Accessed 7/8/2012