Ewing Sarcoma: Tests After Diagnosis

March 21, 2017

Ewing Sarcoma: Tests After Diagnosis

Once Ewing sarcoma has been diagnosed, you’ll likely need other tests to learn more about the cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of the body. The test results help your healthcare providers decide the best ways to treat the cancer. If you have any questions about these or other tests, be sure to talk with your healthcare team.

These tests can include:

  • Computed tomography (CT) scan of your chest

  • Magnetic resonance imaging (MRI)

  • Bone scan

  • Positron emission tomography (PET) scan

  • Bone marrow biopsy

Imaging tests to look for cancer spread

CT scan of your chest

During a CT scan (also called a CAT scan or spiral CT scan), your healthcare provider takes X-rays to scan a part of your body to make detailed pictures. You may have this done on your chest or abdomen. You may need a CT scan of your chest to check if the cancer has spread to your lungs.

To have the test, you lie still on a table as it slowly slides through the center of the CT scanner. A computer uses the data from the X-rays to make many detailed pictures. A CT scan is painless. Your healthcare provider may ask you to hold your breath one or more times during the scan. In some cases, you’ll get an intravenous (IV) drip with a contrast medium before the scan. This helps tumors show up better during the scan. Your healthcare provider may ask you not to eat anything in the time between drinking the contrast and the scan. The contrast will slowly pass through your system and exit through your bowel movements.


An MRI uses magnets, radio waves, and a computer to make detailed pictures of the inside of your body. An MRI may be used to learn the exact size and extent of the spread of the main tumor. Your healthcare provider may also use it to look for areas of cancer spread in other parts of your body. In some cases, you’ll receive a contrast dye by injection before getting the scan. 

MRIs aren’t painful. They can, though, take a long time to do. They may take up to an hour. During that time, you’ll need to lie still on a table that’s moved into a long, narrow tube. If you have a fear of enclosed spaces or are a young child, your healthcare provider may give a sedative to help you stay calm during the test. Newer, more open MRI machines can sometimes be used instead. But the images may not be as sharp in some cases. The equipment also makes loud banging noises during the test. You can ask for earplugs if you think the noise will bother you.

Because the test uses powerful magnets, you won’t be allowed to have anything metal in the room. Even eyeglasses and ballpoint pens can become dangerous projectiles when the magnets are turned on. If you have any kind of metal implant, such as a heart valve or a joint pin, you may not be able to have an MRI. This depends on the type of metal it’s made of. And the equipment can affect implants, such as a pacemaker. 

Bone scan

A bone scan is often done to let your healthcare provider see the whole skeleton at once, to look for the spread of bone tumors anywhere in the body. For this test, a slightly radioactive substance that is attracted to changes in bones (which might be from cancer) is injected into your vein. The substance travels through the bloodstream and collects in areas of abnormal bone growth. A special camera can then show where this substance collects.

PET scan

A PET scan can also look for spread of the cancer to the bones, as well as other parts of the body. The picture isn’t as detailed as a CT scan. But it can often show abnormal areas throughout your body. 

For this test, a mildly radioactive sugar is injected into a vein. Cancer cells absorb more of this sugar than normal cells, and the radioactive material shows up during the image from the scan. To have the scan, you’ll need to lie still on a table that’s pushed into the PET scanner. This is a machine that takes pictures that show where the sugar is in your body. The whole process may take several hours. 

Some machines can do a PET scan and CT scan at the same time (PET/CT scan). This can give your healthcare provider even more information about areas of cancer spread,

Procedures to look for cancer spread 

Bone marrow biopsy

This test may be done once Ewing sarcoma has been diagnosed. It can help show if the cancer has spread to the bone marrow. This is the soft, inner part of many bones. For this test, your healthcare provider will use hollow needles to remove samples of bone marrow. It’s usually taken from the back of your hip bones. Teens and adults may be awake when this is done (with the area numbed), but children are usually sedated or asleep.

Working with your healthcare provider

Your healthcare provider will talk with you about which tests you need. Make sure to get ready for the tests as instructed. Ask questions and talk about any concerns you have.


March 21, 2017


Clinical presentation, staging, and prognostic factors of the Ewing sarcoma family of tumors. UpToDate.

Reviewed By:  

Alteri, Rick, MD,Gersten, Todd, MD