A precise and thorough diagnosis is essential for planning the most effective treatment program for osteosarcoma. At Sheba Medical Center, our pediatricians, pediatric oncologists, and other specialists use advanced technologies and superior skill to evaluate all test results quickly and comprehensively. We use a variety of diagnostic procedures to determine the exact type of tumor your child has and to assess whether the cancer has spread, including:
During your diagnostic evaluation at Sheba, we may perform the following procedures:
Bone x-ray of the area of pain/swelling
Typically, this is the first procedure that we perform if osteosarcoma is suspected. Our physicians can often identify a bone tumor based on plain x-rays of the bone. However, other imaging tests are also usually required to confirm the cancer.
We may use CT scans, which are more detailed than general x-rays, to create detailed images of different parts of the body, including muscles, bones, and fat. If a bone x-ray shows the presence of a tumor, a CT scan may be used to check if the tumor has spread.
During this laboratory test, cells are exposed to chemical stains that only react with leukemia cells. This helps the doctors determine if leukemia cells are present and if so, which type.
MRI scans, which are usually more precise than CT scans, use radio waves and strong magnets to generate highly detailed images of soft tissues in the body. Our doctors may use MRI scans to see a more accurate view of a bone mass observed on an x-ray; this is generally an effective way to determine if the mass is a tumor, infection, or other type of bone damage. Because MRI scans can also show the marrow inside bones and soft tissues surrounding a tumor, they are helpful at showing the exact extent of osteosarcoma. This is critical information for planning surgery.
Imaging tests may indicate that your child has some type of bone cancer, but only a biopsy can confirm the diagnosis. A biopsy involves removing a small piece of the tumor to view it under a microscope and perform additional lab testing. If the tumor is in a bone, an experienced orthopedic surgeon will usually perform the biopsy. A biopsy is the best method for differentiating osteosarcoma from other types of bone cancer in children.
A bone scan may be included in the testing procedures for children with osteosarcoma because it can show the entire skeleton at once. While the results of a bone scan may suggest areas of cancer, additional testing (x-rays, MRI scans, bone biopsy) is also usually needed in order to make a precise diagnosis.
While blood tests are not needed to diagnose osteosarcoma, they can provide important information after diagnosis. For example, high levels of certain chemicals in the blood, such as alkaline phosphatase and lactate dehydrogenase (LDH), can indicate that the osteosarcoma is at an advanced stage.