Recent imaging advancements for lung metastases in children with sarcoma

In children and adolescents affected by musculoskeletal sarcomas (both soft tissue and bone sarcomas), the presence of lung metastases is a frequent complication, that should be known since the patient's prognosis, management, and treatment depend on it. During the staging phase, the detection of lung metastases should be sensitive and specific, and it should be carried out minimizing the radiation exposure. To face this problem, imaging has reached important goals in recent years, thanks to the development of cone-beam CT or low-dose computed tomography, with some new iterative reconstruction methods, such as Veo and ASIR. Imaging is also fundamental for the possibility to perform lung biopsies under CT guidance, with less morbidity, less time-consuming, and the shorter recovery time, compared to surgical biopsies. Moreover, important results have also been demonstrated in the treatment of lung metastases, thanks to the improvement of new mini-invasive image-guided percutaneous thermal ablation procedures, which proved to be safe and effective also in young patients.