European guideline for imaging of primary paediatric and adult osteosarcoma and Ewing sarcoma: systematic…

GuidelineThe Lancet. Oncology· Jul 2026

European guideline for imaging of primary paediatric and adult osteosarcoma and Ewing sarcoma: systematic review and joint statement by the FOSTER consortium, Euro Ewing Consortium, European Society of Paediatric Radiology, and the European Association of Nuclear Medicine.

Laura M E Adriaansen, Johannes H M Merks, Elvira C van Dalen … Rick R van Rijn

OncologyGuidelineClinical practiceQ1IF 9.4

European guideline issues 32 consensus recommendations for osteosarcoma and Ewing sarcoma imaging.

European guideline for imaging of primary paediatric and adult osteosarcoma and Ewing sarcoma: systematic review and joint statement by the FOSTER consortium, Euro Ewing Consortium, European Society of Paediatric Radiology, and the European Association of Nuclear Medicine.

Laura M E Adriaansen … Rick R van Rijn

The Lancet · Jul 2026

Background

Imaging is central to diagnosing, staging, evaluating treatment response, and guiding post-therapy surveillance in osteosarcoma and Ewing sarcoma, yet no international consensus defines optimal modalities or schedules.

Purpose

This European guideline, developed by 36 multidisciplinary experts, seeks to standardise imaging for research and enhance patient care.

Methods

A systematic review identified 2026 studies, of which 13 met criteria, revealing marked heterogeneity in diagnoses, chemotherapy regimens, and imaging protocols.

n = 2026 studies

32

Results

32

the guideline issued consensus recommendations for imaging bone and soft tissue cancers

n = 2026 studies

More results

Evidence remains inconclusive regarding the optimal modality for detecting bone metastases, and no metabolic imaging indices or MRI parameters consistently predict response or survival.

Data are similarly insufficient to define the ideal frequency of post-treatment surveillance.

“

Conclusion

Substantial evidence gaps persist, underscoring the need for international prospective imaging studies to establish robust, harmonised standards for future patient care.

European guideline for imaging of primary paediatric and adult osteosarcoma and Ewing sarcoma: systematic review and joint statement by the FOSTER consortium, Euro Ewing Consortium, European Society of Paediatric Radiology, and the European Association of Nuclear Medicine.

European guideline for imaging of primary paediatric and adult osteosarcoma and Ewing sarcoma: systematic review and joint statement by the FOSTER consortium, Euro Ewing Consortium, European Society of Paediatric Radiology, and the European Association of Nuclear Medicine.

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