The purpose of this book is to integrate the most re- butions and support of my colleagues and friends cent advances in the diagnosis and treatment of pedi- at The University of Texas Southwestern Medical atric bone and soft tissue sarcomas. The book is di- School,St. Jude Children's Research Hospital,and the vided into two major sections,the ?rst of which pres- Hospital for Sick Children in Toronto. In particular,I ents salient concepts in epidemiology,the impact of would like to thank Drs. George Buchanan, Charles novel tools in imaging and molecular biology,and the Pratt,William Crist, David Parham, Jim Anderson, underlying principles for continued drug develop- and Larry Kun for their friendship,mentorship,and ment. In the second section,the book embarks on an wisdom. Their teachings will continue to be an e- up-to-date survey of the diagnosis and treatment of less source of passion and inspiration. It is my wish each speci?c disease,with particular emphasis on the that this book will provide answers, guidance and need for an integrative, multidisciplinary approach hope to medical professionals, children, and their to diagnosis and treatment. families. I am indebted to my colleagues and collaborators who have contributed their ideas, time, and kno- edge to this project. I am also grateful for the contri- Alberto Pappo,MD IX Contents 1 Epidemiology of Bone 3 Diagnostic Imaging of Pediatric Bone and Soft Tissue Sarcomas and Soft Tissue Sarcomas Logan G. Spector,Julie A. Ross, Thomas D. Henry,Mary E. McCarville, Rajaram Nagarajan Fredric A.