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World class sarcoma care in the West Midlands

Diagnostics

You have been referred to our service because your doctor or consultant thinks that you may have a sarcoma. The majority of patients who are referred to us do not have a sarcoma and have another benign condition which may be treated by us or referred elsewhere as appropriate. As a specialist sarcoma centre our multidisciplinary team have the expertise to quickly investigate your symptoms, give you a diagnosis and ensure that you get the right treatment. Some benign tumours such as desmoid fibromatosis and giant cell tumours of the bone are also best treated by a specialist sarcoma team. 

The different types of diagnostic tests we may use are:

MRI scan

A Magnetic Resonance imaging (MRI) scan is a type of whole body scan that relies on the use of a very powerful magnetic field to provide a very detailed picture of the structures within the body. It is very useful for evaluating the soft tissues in the body such as the spinal cord, muscles and connective tissues. It does not use radiation so is a very safe procedure. It takes a slightly longer time to complete the scan that other types of imaging and it is quite noisy. Due to the presence of the magnetic field it is very important to inform your treating team if you have any metallic implants at all including pacemakers and cardiac/intra-cranial stents. The scan requires you to lie still and flat for the duration of the process. For further information please click here.

CT Scan

A Computerised Tomography (CT) scan takes multiple x-ray images which are then combined by a computer to provide a rapid detailed view of different structures within the body. It is often used for imaging of bones, the lungs or other structures which are sometimes enhanced by injection of a special dye into the bloodstream. It is frequently used in the diagnosis of sarcoma by allowing accurate insertion of biopsy needles to obtain tissue samples for testing – this would be done only under an anaesthetic. It is quicker than an MRI scan but does impart some radiation to the patient. For more information on CT scans please click here.

Biopsy

One of the investigations into the condition that you have been referred for is likely to involve undergoing a biopsy. This is a process by which a sample of the tumour tissue can be obtained and analysed under a microscope. This allows the Histopathologist (the doctor who studies cells and tissue in detail) to make a diagnosis and confirm whether tumour or mass is cancerous or not. This then dictates the type of treatment you may require, if any. There are many different techniques of performing a biopsy. These include image guided biopsy using a CT scan or an Ultrasound machine. It is also possible in certain situations to perform a biopsy in the clinic under local anaesthetic. Sometimes a biopsy is performed in theatre under a general anaesthetic this is called either an open biopsy or an excision biopsy. 1 in 10 biopsy samples do not yield enough tissue to allow a diagnosis so in the minority of cases a further biopsy may be required.

CT Guided Biopsy

This is the process of obtaining the biopsy whilst in a CT scanner. It is useful for performing biopsies of bone or deep structures as the scanner allows the accurate placement of the biopsy needle into the tumour tissue. As this can be an involved procedure and take longer than a normal scan it will be done under a general anaesthetic. This is more comfortable for the patient and allows the patient to lie still for a longer period of time. It is a day case procedure so you will leave on the same day but someone will need to drive you home after receiving a general anaesthetic. Exceptionally some patients will stay overnight prior to going home the following day. 

For more information about CT Guided biposies:

Ultrasound Guided Biopsy

An ultrasound scan (USS) is a handheld device that allows a quick two-dimensional assessment of a superficial structure. It relies on soundwaves and therefore does not involve radiation. The process of an ultrasound guided biopsy is similar to that of a CT guided procedure in that it allows accurate placement of the biopsy needle into the mass. It is used for more superficial swellings and is not used to biopsy bone. It is performed in the dedicated sonography room in the outpatient’s clinic. No general anaesthetic is required only a local anaesthetic to the skin. This makes it a relatively quick procedure that allows you to return home shortly after its completion.