Diagnosing Tumors

During your family’s first appointment at the Orthopedic Tumor Program, we’ll discuss your child’s detailed medical history, perform a physical exam, and likely perform imaging and/or laboratory studies that require drawing blood.

If a biopsy is necessary to determine the type of tumor your child has, it will be performed by our orthopedic oncologist. The biopsy will help determine whether the tumor is benign (a type of tumor that is not likely to spread from the original area) or malignant (likely to spread from the original area). If a biopsy was already performed before your child came to Children’s Hospital Colorado, another biopsy may or may not be necessary.

Learn why parents choose our Orthopedic Tumor Program.

Staging Studies

In addition to determining whether your child’s tumor is benign or malignant, the orthopedic tumor team may perform other tests to further classify the tumor. This series of tests is known as staging. The tests will determine the extent of the tumor, and if it has spread to other areas of the body.

These tests help give your child's care team at Children’s Colorado the information we need to provide the most effective treatment for the tumor. Some of these tests may be performed before your child’s surgeon obtains a biopsy. Each study is listed below, along with information and instructions for how to prepare your child to help us get the most accurate results.

Bone Scan

A bone scan is a nuclear imaging study done to detect bone tumors and determine other abnormalities in bones. Your child’s doctor may order a bone scan with contrast, which means your child will have dye injected into a vein two hours before the scan.

It is important that your child be well hydrated for this study. Your doctor will give you detailed instructions on how to prepare for the bone scan and when to arrive at the radiology department.

PET Scan

A PET scan is a nuclear imaging study that 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 help ensure accurate results, your child’s doctor or nurse will give you specific preparations for the scan, such as:

• No caffeine or aggressive exercise for 24 hours before the test.
• Eat a diet low in sugar the day before the test.
• Do not eat for eight hours before the test.
• Drink only water during the eight hours before the test.
• Two hours before the test, you child can have nothing to eat or drink. However, it is recommended that your child be well-hydrated, so please encourage him or her to drink lots of water up to two hours before the test.

CT Scan

A CT 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 a tumor in the bone, as well as tumor cells in the chest and lungs.

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

MRI Scan

An 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.

The MRI scan can be done with or without contrast. If contrast is needed, your child will receive an IV two hours prior to the test. Your child’s care team at Children’s Colorado team will provide specific instructions before the MRI.

Learn why a children’s hospital is the best place for pediatric tests.

What to Expect From the Tests

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. Depending on the study, you may be able to stay in the testing room with your child 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 will monitor his or her heart rate and blood pressure. Afterwards, a nurse will take care of your child until he or she is 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 before the study to help them relax. Additionally, the radiology staff will explain the study and talk to your child during the study. Please tell the doctor 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 tests, and patients getting an MRI may be able to watch a movie. Feel free to ask the radiology staff if these options are available during your child’s test.