INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) Consensus Statement: Imaging Recommendations for the Management of Rhabdomyosarcoma

• Published in: European journal of radiology Vol. 166; p. 111012
• Main Authors: Schoot, Reineke A, van Ewijk, Roelof, von Witzleben, Anna-Anais, Kao, Simon C, Merks, JHM Hans, Morosi, Carlo, Pace, Erika, Shulkin, Barry L, Ferrari, Andrea, von Kalle, Thekla, van Rijn, Rick R, Weiss, Aaron R, Sparber-Sauer, Monika, AJ ter Horst, Simone, Beth McCarville, M.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2023
• Subjects: International sarcoma consortium; metastatic disease; pediatric rhabdomyosarcoma; rhabdomyosarcoma imaging; soft-tissue neoplasm; RECIST; metastatic disease; International sarcoma consortium; rhabdomyosarcoma imaging; soft-tissue neoplasm; SOR; FDG; COG; EpSSG; INSTRuCT; pediatric rhabdomyosarcoma; Metastatic disease; Soft-tissue neoplasm; Pediatric rhabdomyosarcoma; Rhabdomyosarcoma imaging
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2023.111012

•Criteria developed by INSTRuCT group for international consensus recommendations.•Criteria defining pulmonary metastatic disease in rhabdomysarcoma patients provided.•Recommendations for the management of indeterminate pulmonary nodules are provided.•Guidelines are based on a rigorous review of recent literature using GRADE criteria.•Strength of Recommendation score assigned based on expert opinion and experience.•A standardized approach to surveillance imaging was developed based on the Oberlin score. Rhabdomyosarcoma is the most common soft-tissue neoplasm in the pediatric population. The survival of children with rhabdomyosarcoma has only marginally improved over the past 25 years and remains poor for those with metastatic disease. A significant challenge to advances in treatment of rhabdomyosarcoma is the relative rarity of this disease, necessitating years to complete clinical trials. Progress can be accelerated by international cooperation and sharing national experiences. This necessitates agreement on a common language to describe patient cohorts and consensus standards to guide diagnosis, treatment, and response assessment. These goals formed the premise for creating the INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) in 2017. Multidisciplinary members of this consortium have since developed international consensus statements on the diagnosis, treatment, and management of pediatric soft-tissue sarcomas. Herein, members of the INSTRuCT Diagnostic Imaging Working Group present international consensus recommendations for imaging of patients with rhabdomyosarcoma at diagnosis, at staging, and during and after completion of therapy. The intent is to promote a standardized imaging approach to pediatric patients with this malignancy to create more-reliable comparisons of results of clinical trials internationally, thereby accelerating progress in managing rhabdomyosarcoma and improving survival.