Diagnosing Tumors

When you and your child first meet with a physician from the Othopedic Oncology Program they will determine what type of tumor your child has by performing a biopsy .The biopsy will determine whether the tumor is benign (it has not spread from the original site of origin) or malignant (it has spread to other areas in the body). Your doctor or nurse practitioner will also take a detailed medical history and give your child a physical examination.

Staging Studies

In addition to determining whether your child’s tumor is benign or malignant, the orthopedic oncology team will perform other tests to further classify the tumor. This is known as staging. There are several tests that will be done to determine the extent of the tumor, if it is continuing to grow or if it has spread to other areas of the body.

The tests will assist your child's care team in providing the most effective treatment for their tumor. These tests will generally be perfromed before your child’s surgeon obtains a biopsy. Each study is listed below, along with information and instructions for how to prepare your child so the most accurate results are obtained.

Bone Scan

A bone scan is a nuclear imaging study done to detect bone tumors and determine other abnormalities in bones. Sometimes the doctor will order a bone scan with contrast, for which your child will have dye injected into a vein two hours before the scan is done. It is important that your child be well hydrated for this study. Your doctor will give you detailed instrucions on how to prepare for this study and when to arrive at the radiology department.

PET Scan

A PET scan is a nuclear imaging study which also detects tumors in the bone and surrounding soft tissues in the body. This is a very sensitive test that will pick up any abnormalities. To ensure accurate results there are specific preparations for the scan, which your doctor or nurse will share with you.

Generally, your child will be instructed to have no caffeine or aggressive exercise for 24 hours before the test. Additionally, they are to eat a diet low in sugar the day before the test. Your child may not eat or drink other liquids for 6 hours before the test. However, they can have water up to the time of the test and it is recommended that the child be well hydrated for the test.

CT Scan

A CT or CAT scan is an imaging study that uses a combination of x-ray and computer technology to produce cross-sectional images of the body, including bones, muscles, fat and organs. CT scans are primarily used to check for tumor cells in the chest and lungs.

Sometimes the patient will need to drink contrast solution before the scan (provided by the radiology department) – your doctor and/or nurse will give you detailed instructions if this is or isn’t necessary.

MRI Scan (magnetic resonance imaging)

A MRI scan is a study that uses a combination of large magnets, radiofrequency and a computer to produce detailed images of structures in the body.  It is used to determine the extent of the tumor within the bone and soft tissues. Typically, the patient cannot have any solid food or milk products for 6 hours before the study. They may have clear liquids until 2 hours before the study. Your healthcare team will provide specific instructions.

What to Expect

Most of these tests will last between thirty minutes to one hour. Your child will typically need to lie still during the test to get the most accurate results. You may stay in the testing room with your child during the study to talk to them and calm their fears.

If your child is small, or you do not think they can lie still for the duration of the test, an anesthesia provider will give your child medicine to fall asleep during the study. The anesthesia provider will stay with your child during the study and they will monitor their heart rate and blood pressure. Afterwards, a nurse will take care of your child until they are awake. You may stay with your child during this time.

If your child is older and nervous about the study or test, medication can be given to them before the study to help them relax. Additionally, the radiology staff will explain the study to them and will talk to them during the study. Please tell your physician or nurse if you think that medicine will be of benefit to your child.

Older children will be offered headphones to listen to their favorite music during some test and patients getting MRI may be able to watch a movie during their study. Before your child is scheduled to have their study, feel free to ask the radiology if these options are available.