Clinical and Prognostic Role of 18F-FDG PET/CT in Pediatric Ewing Sarcoma

Albano, Domenico; Dondi, Francesco; Schumacher, Richard Fabian; D’Ippolito, Carmelita; Porta, Fulvio; Giubbini, Raffaele; Bertagna, Francesco

doi:10.1097/mph.0000000000001518

Cited by 19 publications

(18 citation statements)

References 38 publications

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“…18 F–FDG PET/CT is widely used to characterize tumor glycolytic activity, which is a valuable marker of tumor biological behavior [ 16 , 17 ]. In the present study, we assessed the usefulness of 18 F–FDG PET/CT in differentiating STS and BS from benign lesions.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

et al. 2020

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Background Accurate differentiation between malignant and benign changes in soft tissue and bone lesions is essential for the prevention of unnecessary biopsies and surgical resection. Nevertheless, it remains a challenge and a standard diagnosis modality is urgently needed. The objective of this study was to evaluate the usefulness of 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions. Methods Patients who had undergone pre-treatment 18 F-FDG PET/CT imaging and subsequent pathological diagnoses to confirm malignant (STS and BS, n = 37) and benign ( n = 33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, PET and low-dose CT visual characteristics, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneous factor (HF) of each lesion were measured. Univariate and multivariate logistic regression analyses were conducted to determine the significant risk factors to distinguish sarcoma from benign lesions. To establish a regression model based on independent risk factors, and the receiver operating characteristic curves (ROCs) of individual parameters and their combination were plotted and compared. Conventional imaging scans were re-analyzed, and the diagnostic performance compared with the regression model. Results Univariate analysis results revealed that tumor size, SUVmax, MTV, TLG, and HF of 18 F-FDG PET/CT imaging in the STS and BS group were all higher than in the benign lesions group (all P values were < 0.01). The differences in the visual characteristics between the two groups were also all statistically significant ( P < 0.05). However, the multivariate regression model only included SUVmax and HF as independent risk factors, for which the odds ratios were 1.135 (95%CI: 1.026 ~ 1.256, P = 0.014) and 7.869 (95%CI: 2.119 ~ 29.230, P = 0.002), respectively. The regression model was constructed using the following expression: Logit ( P ) = − 2.461 + 0.127SUVmax + 2.063HF. The area under the ROC was 0.860, which was higher than SUVmax (0.744) and HF (0.790). The diagnostic performance of the regression model was superior to those of individual parameters and conventional imaging. Conclusion The regression model including SUVmax and HF based on 18 F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.

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Section: Discussionmentioning

confidence: 99%

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

et al. 2020

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“…We identified 10 studies providing quantitative data describing the incidence of BMM in all unselected patients with newly diagnosed ES (Table 1). 21,[23][24][25][26][27][28][29][30][31] These studies ranged in year of publication from 1995 to 2020. Eight studies were completed in a retrospective manner, one was a phase 3 clinical trial, and one was a pilot trial.…”

Section: Quantitative Analysis: Incidence Of Bmmmentioning

confidence: 99%

Role of bone marrow biopsy for staging new patients with Ewing sarcoma: A systematic review

Campbell

Shulman

Grier

et al. 2020

Pediatric Blood & Cancer

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The incidence of bone marrow metastasis (BMM) in newly diagnosed Ewing sarcoma (ES) is variable across studies. An optimal staging strategy for detecting BMM is not defined. While bone marrow (BM) biopsy and/or aspirate (BMBA) have been the gold standard, [F-18]fluorodeoxyglucose positron emission tomography (FDG-PET) to detect BMM may decrease reliance on BMBA. We conducted a systematic review to assess incidence of BMM and the role of FDG-PET. We observed a pooled incidence of BMM by BMBA of 4.8% in all newly diagnosed ES patients and 17.5% among patients with metastatic disease. Only 1.2% of patients had BMM as their sole metastatic site. FDG-PET detection of BMM compared to BMBA demonstrated pooled 100% sensitivity and 96% specificity, positive predictive value of 75%, and negative predictive value of 100%. In the era of FDG-PET imaging, omission of BMBA may be considered in patients with otherwise localized disease after initial staging studies.

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“…F-FDG PET/CT is widely used to characterize tumor glycolytic activity, which is a valuable marker of tumor biological behavior [16,17]. In the present study, we assessed the usefulness of 18 [17,19].…”

Section: Discussionmentioning

confidence: 99%

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F- FDG PET/CT-derived parameters

Chen

Feng

Xie

et al. 2020

Preprint

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Background: Accurate differentiation between malignant and benign changes in soft tissue and bone lesions is essential for the prevention of unnecessary biopsies and surgical resection. Nevertheless, it remains a challenge and a standard diagnosis modality is urgently needed. The objective of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (18F-FDG) PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions. Methods: Patients who had undergone pre-treatment 18F-FDG PET/CT imaging and subsequent pathological diagnoses to confirm malignant (STS and BS, n = 37) and benign (n = 33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, PET and low-dose CT visual characteristics, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneous factor (HF) of each lesion were measured. Univariate and multivariate logistic regression analyses were conducted to determine the significant risk factors to distinguish sarcoma from benign lesions. To establish a regression model based on independent risk factors, and the receiver operating characteristic curves (ROCs)of individual parameters and their combination were plotted and compared. Conventional imaging scans were re-analyzed, and the diagnostic performance compared with the regression model.Results: Univariate analysis results revealed that tumor size, SUVmax, MTV, TLG, and HF of 18F-FDG PET/CT imaging in the STS and BS group were all higher than in the benign lesions group (all P values were <0.01). The differences in the visual characteristics between the two groups were also all statistically significant (P <0.05). However, the multivariate regression model only included SUVmax and HF as independent risk factors, for which the odds ratios were 1.135 (95%CI: 1.026~1.256, P = 0.014) and 7.869 (95%CI: 2.119~29.230, P = 0.002), respectively. The regression model was constructed using the following expression: Logit (P) = -2.461+0.127SUVmax+2.063HF. The area under the ROC was 0.860, which was higher than SUVmax (0.744) and HF (0.790). The diagnostic performance of the regression model was superior to those of individual parameters and conventional imaging.Conclusion: The regression model including SUVmax and HF based on 18F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.

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Clinical and Prognostic Role of 18F-FDG PET/CT in Pediatric Ewing Sarcoma

Cited by 19 publications

References 38 publications

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

Role of bone marrow biopsy for staging new patients with Ewing sarcoma: A systematic review

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F- FDG PET/CT-derived parameters

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