Mandatory medical device diagnostics.
- Conventional radiography of the affected body region, in two planes – to assess the extent of tumor growth; often lacks malignancy criteria
- Computed tomography (CT; cross-sectional imaging (radiographs taken from different directions with computer-based evaluation)) – for the purpose of determining the location, size, and extent of the tumor (bone destruction/destruction?), rate of growth (aggressiveness), and to detect skip metastases (nearby metastases)
- Computed tomography (CT) of the abdomen (abdominal CT)/pelvis (pelvic CT).
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays)) – for the purpose of determining the location, size, and extent of the tumor (soft tissue infiltration? intramedullary spread in the bone marrow? Involvement of the spinal canal?) and for the detection of skip metastases (nearby metastases).
- Positron emission tomography (PET), if necessary – as a baseline examination to assess response to therapy.
Spread diagnostics (“staging”) (metastasis?) – if the suspected diagnosis of a bone tumor has been confirmed.
- Computed tomography of the thorax (thoracic CT) – to detect distant metastases in the lungs.
- Positron emission tomography (PET), if necessary – to detect distant metastases.
Lodwick classification
By means of the Lodwick classification, it is possible to assess whether the tumor is benign (benign) or malignant (malignant) on an X-ray. Furthermore, it is suitable for the assessment of progression in the case of aggressive behavior of the tumor.
An index for the growth rate of the bone tumor or an inflammatory process is the reaction visible on the X-ray, i.e. the bone structure is modified locally, regionally or diffusely by the tumor. The visible patterns of destruction are classified into the following main groups:
| Grade | Growth rate | Bone destruction | Dignity* | Bone tumors |
| Grade I | Purely geographic (circumscribed); boundary definable | |||
|
Very slow growing | Sclerosis (pathological hardening of here: tissues) and sharp boundary | benign | Chondroblastoma, enchondroma, fibrous bone dysplasia, nonossifying fibroma, osteoid osteoma |
|
Slow growing (displacing) | Bone distention > 1 cm and/or no sclerosis | actively benign | Giant cell tumor |
|
Mean growth rate(locally invasive) | Total compact penetration (compacta = outer marginal layer of bone). | aggressive benign | chondro-, osteo-, fibrosarcomas |
| Grade II | fast growing | Geographic, with moth-eaten/permeated (without respect for anatomical boundaries) component | predominantly malignant | Chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma, metastases, osteosarcoma |
| Grade III | very fast growing | purely moth-eaten or permeative destruction | malignant | Ewing’s sarcoma |
* biological behavior of tumors; that is, whether they are benign (benign) or malignant (malignant)The classification is particularly suitable for tumors of a long bone or small bone. However, it is neither sensitive nor specific, so further diagnostic measures are usually indispensable.