Diagnostic and staging studies at the time of initial presentation of rhabdomyosarcoma

All patients

CT or MRI scan of primary tumor area

Studies for subsets of patients with specific indications

CT scan of chest, without contrast (T2 or N1 disease)

Whole-body nuclear bone or PET-CT scan (positive chest CT or N1 disease, or T2N0 disease with unfavorable histology)

Thin-cut (5 mm section) CT scan of abdomen and retroperitoneum (all tumors below the diaphragm, including genitourinary primaries)

Ultrasound (pelvic tumors)

Bilateral bone marrow aspirate and biopsy (positive chest CT or N1 disease, or T2N0 disease with unfavorable histology)

Lumbar puncture (parameningeal primary with intracranial extension, tumor involving the eye or orbit with meningeal invasion)

Cytological evaluation of pleural effusion or ascites

CT: computed tomography; MRI: magnetic resonance imaging; PET: positron emission tomography.

Graphic 73916 Version 7.0