Imaging in Sarcoma

Eary, Janet F.; Conrad, Ernest U.

doi:10.2967/jnumed.111.092999

Cited by 42 publications

(12 citation statements)

References 52 publications

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“…The literature shows that SUVmax values for the differentiation between benign and malignant tumors vary between 1.3 and 4.0 across Institutions and publications, due to the different equipment and protocols used, as well as differences in lesion histology (Eary and Conrad 2011; Eary et al 2002). …”

Section: Discussionmentioning

confidence: 99%

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

et al. 2016

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The differential diagnosis between chondroma and intraosseous chondrosarcoma is based on imaging and clinical exams, but only a biopsy can confirm diagnosis. The aim of this study was to evaluate the value of PET–CT in differentially diagnosing chondroma and chondrosarcoma. From October 2009 to May 2015, 36 patients with cartilaginous bone lesions in the extremities, 12 (33.3 %) men and 24 (66.6 %) women, were prospectively included in the study. Patients ranged in age from 21 to 68 years, with a mean age of 44 years. Lesions were located in the long bones: in the proximal humerus in 26 (72.2 %) patients, in the femoral shaft in 1 (2.7 %), in the distal femur in 7 (19.4 %), and in the proximal tibia in 2 (5.5 %). The SUVmax value of 2.0 was used to separate between patients submitted to surgery and patients submitted to observation. Among the 36 patients studied, 17 (47.2 %) had SUVmax ≤ 2.0, and they were diagnosed as chondroma and they were treated conservatively. Follow-up ranged from 14 to 76 months, averaging 38 months. Nineteen (52.7 %) patients with SUVmax >2.0 were diagnosed as chondrosarcoma and underwent surgery. The area of the curve, calculated considering the SUV variable as numeric, is estimated in 0.966, with a 95 % confidence interval from 0.906 to 1.000. To evaluate the sensitivity, specificity and positive/negative predictive values, it was built a 2 × 2 table. Significance was set at p < 0.05. According the criteria of maximum sensitivity and specificity, the cut point suggested to SUVmax was 2.2. If we consider this point, it is possible to identify 19 of 36 positive cases to chondroma (52.8 %), it means, all chondrosarcomas of the series. We concluded that PET–CT can be used as an objective and quantitative method of differentiating between chondromas and chondrosarcomas located within the long bones. It represents a complementary examination to standard imaging (X-ray, scintigraphy, CT and MRI) and pathological exams. The SUVmax between 2.0 and 2.2 would be a range area between chondroma and chondrosarcoma and this range can be of value, among others exams, in decide the best treatment for patients with cartilaginous lesions in long bones.Level of evidence Level I—diagnostic study—prospectively investigating a diagnostic test using a universally applied “gold” standard.

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Section: Discussionmentioning

confidence: 99%

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

et al. 2016

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“…Myxofibrosarcoma is a sarcoma type that develops mostly in the extremities [2]. Nuclear medicine imaging studies for sarcomas (soft tissue or bone derived) have included technetium-99m methylene diphosphonate (MDP) bone scan and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) [3]. We are aware of no published reports describing Indium-111 white blood cell localization to a soft tissue sarcoma in an extremity.…”

Section: Discussionmentioning

confidence: 99%

Indium-111 labeled leukocyte accumulation in extremity soft tissue sarcoma

Fong

Johnson

2017

Radiology Case Reports

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Nuclear medicine labeled leukocyte whole-body scintigraphy is commonly used to identify a source of infection in a patient with fever of unknown origin. White blood cells can also localize to other sites of inflammation, including sometimes tumors. A patient with a large myxofibrosarcoma in his left forearm was scanned due to chronic low-grade fever and persistent leukocytosis. This case demonstrates focal white blood cell activity in an extremity soft tissue sarcoma.

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“…Several previously published reports have addressed the useful application of 18 F‐FDG PET and 18 F‐FDG PET/CT for sarcoma staging, grading, therapeutic monitoring, and prognostic stratification in adult and pediatric patient populations 11, 30‐42. However, to date, among patients who have recurrent sarcoma, the role of molecular imaging with 18 F‐FDG PET has been investigated by only a few groups.…”

Section: Discussionmentioning

confidence: 99%

“…Although anatomically based imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) remain the primary diagnostic modalities for evaluating sarcomas, positron emission tomography (PET) with the glucose analog 18 F‐fluorodeoxyglucose ( 18 F‐FDG) is used increasingly to provide complementary information in sarcoma diagnosis and treatment planning 10‐12. Although recurrent sarcoma generally will demonstrate contrast enhancement at CT (CE‐CT) or MRI studies, this phenomenon also can be observed within hypertrophic scar tissue, reactive hyperemia, and capillary sprouting 13‐16.…”

Section: Introductionmentioning

confidence: 99%

¹⁸F‐Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma

Al‐Ibraheem

Buck

Benz

et al. 2012

Cancer

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BACKGROUND: The clinical utility of modern hybrid imaging modalities for detecting recurrent bone or soft tissue sarcoma remains to be determined. In this report, the authors present a clinical study on the diagnostic accuracy and incremental value of integrated 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT) in patients with a history of sarcoma who have clinically suspected disease recurrence. METHODS: Forty‐three patients who had a history of bone or soft tissue sarcoma and had documented complete remission underwent 18F‐FDG PET/CT. Image analysis was performed independently for 18F‐FDG PET (n = 43) and for contrast‐enhanced spiral CT (CE‐CT) (n = 30) by 2 separate readers, whereas combined 18F‐FDG PET/CT (n = 43) images were analyzed in consensus by both readers. Imaging findings were rated on a 5‐point scale and finally were reported as malignant, benign, or equivocal. Imaging findings were validated either by histopathology (n = 24) or by clinical follow‐up (n = 19). RESULTS: 18F‐FDG PET/CT had greater sensitivity and specificity compared with CE‐CT alone (94% and 92% vs 78% and 67%, respectively), resulting in significantly greater accuracy (93% vs 73%; P = .03). 18F‐FDG PET/CT was particularly superior regarding detection of local recurrence or soft tissue lesions (sensitivity and specificity: 83% and 100% vs 50% and 100%, respectively) or bone metastases (100% and 100% vs 85% and 88%, respectively). CONCLUSIONS: 18F‐FDG PET/CT had greater diagnostic accuracy in the detection of recurrent bone or soft tissue sarcoma compared with CE‐CT alone. The detection of local recurrence was the most evident advantage of 18F‐FDG PET/CT over CE‐CT. Cancer 2013. © 2012 American Cancer Society.

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Imaging in Sarcoma

Cited by 42 publications

References 52 publications

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

Indium-111 labeled leukocyte accumulation in extremity soft tissue sarcoma

¹⁸F‐Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma

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Imaging in Sarcoma

Cited by 42 publications

References 52 publications

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

Is PET–CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

Indium-111 labeled leukocyte accumulation in extremity soft tissue sarcoma

18F‐Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma

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¹⁸F‐Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma