How radiology-led pathways are transforming sarcoma diagnosis
Submitted by Dr Priya Suresh, consultant MSK radiologist.
As vice president of the British Society of Skeletal Radiologists and medical director of education and training at the Royal College of Radiologists, I’ve witnessed how radiology-led pathways can revolutionise sarcoma diagnosis. I also chair the Peninsula Sarcoma Advisory Group and have been a core member of the sarcoma multidisciplinary team for 18 years.
The vital role that musculoskeletal radiologists play in early sarcoma diagnosis cannot be overstated. Your report could be the turning point in a patient’s journey.
A pathway that delivers results
In 2009, my colleagues and I established a radiology-led pathway for sarcoma referrals. This patient-centred model allows us to assess patients quickly and take decisive steps to confirm or rule out a diagnosis.
The impact on patient experience has been remarkable. Recently, a patient was referred to our ultrasound clinic by their GP, concerned about a potential sarcoma. I took a clinical history, examined the patient, and performed an ultrasound scan. It turned out to be a simple subcutaneous lipoma. The patient and their partner were hugely relieved, receiving answers immediately and avoiding weeks of anxiety.
In another case, a patient presented with a rapidly enlarging thigh mass. On ultrasound, it appeared as a very heterogeneous and highly vascular lesion, suspicious for sarcoma. I explained next steps, arranged an urgent MRI, and scheduled an ultrasound-guided biopsy. I also contacted the clinical nurse specialist for patient support. They were reassured by how quickly everything was being actioned and having a clear understanding of what would happen next.
The radiologist’s expanded role
Radiologists have a central role in these pathways. We don’t just scan; we examine patients, take a thorough history, and explain the process clearly. We guide next steps and ensure that patients are escalated or discharged appropriately. If a lesion is benign, we discharge with confidence. If it is suspicious, we act quickly to secure a diagnosis. An audit of our pathway in 2024 revealed that 79.1% of patients seen on this pathway are discharged back to their GP by radiologists.
As core members of the sarcoma MDT, we work closely with MSK sonographers, oncologists, plastic surgeons, histopathologists, and CNS teams.
Maintaining standards despite increasing demand
Despite a rise in referrals, our radiology-led pathway means that 99% of patients are still seen within the two-week wait period. It is a responsive, efficient system that supports earlier diagnosis and better outcomes.
The future of soft tissue sarcoma diagnosis
Radiology-led pathways are transforming sarcoma diagnosis—delivering fast, patient-focused, and outcome-driven care. Our model is built on direct clinical involvement: we see the patient, examine them, scan them, and take immediate steps toward early diagnosis. This patient-centred approach highlights the evolving role of the radiologist—not just as a passive image interpreter, but as an active clinical decision-maker.
A key strength of this model lies in the integration of musculoskeletal (MSK) sonographers, who work closely within our team and are supported by MSK radiologists to provide a seamless diagnostic service. This collaborative approach ensures high-quality, timely imaging and clinical assessment from the outset.
There are a few centres in England and Wales offering similar services, and they too have reported improved diagnostic speed, patient experience, and multidisciplinary coordination. It is a model that can be widely adopted, as every trust has the expertise of MSK radiologists. This pathway has been well received by professionals at major national conferences held by the British Sarcoma Group, the British Society of Skeletal Radiologists, and the Society of Radiologists in Training.
Sarcoma Awareness Month 2025
July marks Sarcoma Awareness Month, and for the first time, Sarcoma UK is directly targeting healthcare professionals, including radiologists. As part of their campaign, Sarcoma UK has published a comprehensive online guide to help radiologists spot the imaging clues of sarcoma, available here.
This resource complements the radiology-led pathways we’ve developed and provides valuable support for colleagues who may encounter sarcoma cases infrequently in their practice.
Dr Priya Suresh is vice president of the British Society of Skeletal Radiologists, medical director of education and training at the Royal College of Radiologists and chair of the Peninsula Sarcoma Advisory Group. Imaging lead for sarcoma – University Hospitals Plymouth NHS Trust.
This news story has been sponsored by the companies concerned and does not represent the views or opinions of RAD Magazine.
