Diagnosis
If a person has any symptoms of osteosarcoma, a doctor should conduct a physical examination and take a full medical history. If the doctor still suspects osteosarcoma, he or she may get additional imaging and recommend a biopsy, as detailed below. An accurate biopsy is very important for making the diagnosis of osteosarcoma and getting the correct sequence of treatments. . A biopsy or removal that is performed incorrectly may cause the cancer to spread and may make it difficult to surgically remove the cancer without complications.
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Needle Biopsy
A biopsy is the only way to know for certain if a tumor is osteosarcoma. In a needle biopsy, the doctor uses a long needle to extract a cylindrical tissue sample from the bone. The doctor sends this sample to a laboratory to be examined under a microscope for cancer cells.
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Surgical Biopsy
In a surgical biopsy, the doctor uses a surgical knife to make an incision and remove a sample of bone tissue. The doctor sends this sample to a laboratory to be examined under a microscope for cancer cells.
Bone X-Ray
X-rays use electromagnetic radiation to produce images of the inside of your body. Doctors can often see the size, shape and location of osteosarcomas on regular X-rays.
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Bone Scan
A bone scan uses a radioactive substance to identify cancerous tissues in the bones. A bone scan provides a picture of all of the bones in the body, and allows doctors to detect cancerous tissue not visible on plain X-rays. The radioactive substance collects in these areas and illuminates them on the skeletal X-ray.
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Computed Tomography (CT) Scan
For a CT scan, the patient lies flat on a table while a machine rotates around their body and takes X-ray pictures, producing detailed cross-sectional images of the body. A CT scan produces detailed images of the soft tissues of the body and can show if an abnormality is a tumor, an infection or an area of bone injury. CT scans provide a detailed view of the bone marrow and the soft tissues around the bone, and can help a doctor determine if an osteosarcoma has grown into nearby tissues such as fat, muscles or tendons or spread to other organs.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show “slices” of the body. If the doctor notices an abnormality on a bone X-ray, he or she may order an MRI to inspect it more closely. MRIs show the bone in much more detail than plain X-rays and can help doctors determine the extent of the cancer.
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Positron Emission Tomography (PET) Scan
For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream. This substance collects in malignant (cancerous) cells in the patient's body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of cancer in the patient's body.
Blood Test
The doctor may perform certain blood tests after diagnosis to get an idea of how well the patient's organs are working and to check for any indicators of the disease. The doctor takes a blood sample from the patient and has it examined in a laboratory for the lactate dehydrogenase (LDH) enzyme. Lactate dehydrogenase is usually present in low levels in the body. Raised levels of LDH may indicate advanced disease and internal tissue damage related to cancer in the body. Alkaline phosphatase is another blood enzyme that may be used to track the disease.
