Imaging of Malignant Chest Wall Neoplasms

A presentation of imaging features that may be used to differentiate benign from malignant chest lesions, suggest specific histologic tumor types, and ultimately guide patient treatment.

Course ID: Q00506 Category:
Modalities: , , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 17, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.00
Procedures: 2.00
Neck and Chest: 2.00

Magnetic Resonance Imaging: 2.00
Procedures: 2.00
Body: 2.00

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Endocrine and Oncology Procedures: 2.00

Radiography: 1.00
Procedures: 1.00
Thorax and Abdomen Procedures: 1.00

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Thoracic Section: 2.00

Radiation Therapy: 2.75
Patient Care: 1.75
Patient and Medical Record Management: 1.75
Procedures: 1.00
Treatment Sites and Tumors: 1.00


  1. Introduction
  2. Classification of Chest Wall Malignancies
  3. Evaluation of Chest Wall Malignancies
  4. Role of Imaging
  5. Differentiating Malignant from Benign Neoplasms
  6. Diagnosis and Histopathologic Tissue Sampling
  7. Primary Malignant Osseous Tumors
    1. Chondrosarcoma
    2. Myeloma
    3. Osteosarcoma
    4. Ewing Sarcoma Tumors
  8. Primary Malignant Soft-Tissue Neoplasms
    1. Adipocytic Neoplasms
    2. Vascular Neoplasms
    3. Nerve Sheath Neoplasms
    4. Cutaneous Neoplasms
    5. Fibrohistiocytic Neoplasms
  9. Secondary Neoplasms
    1. Metastatic Disease
    2. Chest Wall Invasion by Thoracic Malignancy
    3. Lymphoma
    4. Radiation-Associated Malignancies
  10. Treatment
  11. Conclusion


Upon completion of this course, students will:

  1. be familiar with the percentage of thoracic malignancies on the chest wall
  2. be familiar with the key features of chest wall neoplasms
  3. identify the imaging modality that utilizes SUVs to distinguish disease
  4. be familiar with the most common finding of radiation-associated malignancies
  5. be familiar with the percentage of chest wall tumors detected at chest radiography
  6. be familiar with the organization that has created a classification system for soft-tissue neoplasms
  7. be familiar with the source of chest wall neoplasms
  8. be familiar with the osseous malignancies identified in the article
  9. identify the advantages of dual-energy subtraction chest radiography
  10. be familiar with routine cross-sectional imaging techniques used for the accurate characterization of chest wall malignancies
  11. identify the disadvantages of using multidetector CT to image chest wall malignancies
  12. identify the MR imaging sequences that are used to reduce the overall imaging time and minimize motion artifacts
  13. be familiar with the use of ultrasound to guide needle biopsy
  14. be familiar with the properties of hemangiomas
  15. be familiar with the techniques for histopathologic tissue sampling
  16. be familiar with biopsy techniques recommended for lesions less than 5 cm
  17. be familiar with the characteristics of an angiosarcoma
  18. be familiar with the CT multidetector findings that apply to UPS
  19. identify the most common primary osseous malignancy of the chest wall
  20. be familiar with the neoplasms that are comprised of malignant plasmacytes
  21. identify the symptoms reported with multiple myeloma
  22. be familiar with the demonstration of extramedullary plasmacytoma on MR
  23. be familiar with the characteristics of osteosarcoma
  24. be familiar with the characteristics of Ewing sarcoma
  25. identify what patients are most commonly affected by Ewing sarcoma
  26. be familiar with the imaging characteristics of Ewing sarcoma at multidetector CT
  27. be familiar with the pathologic subtypes of liposarcoma
  28. be familiar with the most common pathological subtypes of liposarcoma
  29. be familiar with the characteristics of angiosarcoma
  30. be familiar with the characteristics of MPNST neoplasms
  31. be familiar with the neoplasms associated with MPNST
  32. identify the key imaging features used to differentiate liposarcoma
  33. be familiar with the characteristics of DFSP
  34. be familiar with the UPS neoplasm
  35. identify the histologic subtypes of UPS
  36. be familiar with the common patterns of metastatic spread of secondary neoplasms
  37. be familiar with the advantages of MR when detecting chest wall invasion by lung cancer
  38. be familiar with the risk of radiation-associated secondary chest wall malignancy
  39. identify the treatment of choice for chest wall malignancies
  40. be familiar with treatment recommendations for chondrosarcoma