Advantages of 18F FDG-PET/CT over Conventional Staging for Sarcoma Patients

Abstract

The effective management of patients with sarcomas requires accurate diagnosis and staging. Imaging, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) are the most freqently used methods for the detection of the lesion location, size, morphology and structural changes to adjacent tissues; however, these modalities provide little information about tumour biology. MRI is a robust and useful modality in tumour staging of sarcomas, however metabolic-fluorodeoxyglucose positron emission tomography/ computer tomography (F-FDG PET/CT) provides greater accuracy to overall staging in combination with MRI [1]. The advantages of F-FDG PET/CT method compared with CT and MRI is that it provides a whole body imaging, maps the viability of the tumour or the metabolic activity of the tissue. Additionally, PET detects the most agressive part of the tumour, demonstrates the biological behaviour of the tumour and therefore has a predictive value. Little data ara available on the roleof F-FDG PET/CT in the management of sarcomas. The present manuscript aims to provide a review of the major indications ofF-FDG PET/CT for diagnosis, staging, restaging and monitoring response to therapy and to compare its usefulness with the conventional imaging modalities in the management of patients with sarcomas.

Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas

“…In former studies, the intermediate and high-grade malignant lesions have significantly higher FDG-uptake than the low-grade and benign lesions, but 18F-FDG-PET/CT offered inadequate discrimination between the latter two groups [ 3 , 11 ]. Some researchers also tried to find a cutoff to differentiate malignant from benign tumors; the sensitivity and specificity of 18F-FDG-PET/CT for detecting malignant versus benign lesions were 79% and 77% using SUV ≥ 2.0 and 60% and 86% using SUV ≥ 3.0, respectively [ 4 ].…”

“…Unlike extremity STS, the special anatomical cavity contains many different pathological types that can mimic STS. There is yet no such comprehensive study regarding the use of 18F-FDG-PET/CT in retroperitoneal and intra-abdominal STS, considering the limitation of low incidence of STS [ 4 ]. As the establishment of the only sarcoma center in China, the abundant resource provides us an opportunity to afford such an analysis.…”

A metastasis prediction model in non-small cell lung cancer using GLCM_contrast and epithelial mesenchymal transition related genes

“…Because the residual FDG concentration in the initial cancer is low and increases as the cancer progresses, the degree of cancer progression can be evaluated through FDG imaging. This method is also suitable for evaluating cancer metastasis 11 . 18 F-FDG PET/CT imaging was used to predict the chemotherapy response after treatment with an anticancer drug in NSCLC 12 .…”

Estimation of 18F-FDG PET Image Texture Features for Metastasis Prediction in Non-Small Cell Lung Cancer Using Epithelial Mesenchymal Transition-Related Genes

“…Because the residual FDG concentration in the initial cancer is low and increases as the cancer progresses, the degree of cancer progression can be evaluated through FDG imaging. This method is also suitable for evaluating cancer metastasis [11]. 18 F-FDG PET/CT imaging was used to predict the chemotherapy response after treatment with an anticancer drug in NSCLC [12].…”