scholarly journals Diagnostic value of 18F-FDG PET-CT in detecting malignant peripheral nerve sheath tumors among adult and pediatric neurofibromatosis type 1 patients

Author(s):  
Ritch T. J. Geitenbeek ◽  
Enrico Martin ◽  
Laura H. Graven ◽  
Martijn P. G. Broen ◽  
Monique H. M. E. Anten ◽  
...  

Abstract Purpose Detecting malignant peripheral nerve sheath tumors (MPNSTs) remains difficult. 18F-FDG PET-CT has been shown helpful, but ideal threshold values of semi-quantitative markers remain unclear, partially because of variation among scanners. Using EU-certified scanners diagnostic accuracy of ideal and commonly used 18F-FDG PET-CT thresholds were investigated and differences between adult and pediatric lesions were evaluated. Methods A retrospective cohort study was performed including patients from two hospitals with a clinical or radiological suspicion of MPNST between 2013 and 2019. Several markers were studied for ideal threshold values and differences among adults and children. A diagnostic algorithm was subsequently developed. Results Sixty patients were included (10 MPNSTs). Ideal threshold values were 5.8 for SUVmax (sensitivity 0.70, specificity 0.92), 5.0 for SUVpeak (sensitivity 0.70, specificity 0.97), 1.7 for TLmax (sensitivity 0.90, specificity 0.86), and 2.3 for TLmean (sensitivity 0.90, specificity 0.79). The standard TLmean threshold value of 2.0 yielded a sensitivity of 0.90 and specificity of 0.74, while the standard SUVmax threshold value of 3.5 yielded a sensitivity of 0.80 and specificity of 0.63. SUVmax and adjusted SUV for lean body mass (SUL) were lower in children, but tumor-to-liver ratios were similar in adult and pediatric lesions. Using TLmean > 2.0 or TLmean < 2.0 and SUVmax > 3.5, a sensitivity and specificity of 1.00 and 0.63 can be achieved. Conclusion 18F-FDG PET-CT offers adequate accuracy to detect MPNSTs. SUV values in pediatric MPNSTs may be lower, but tumor-to-liver ratios are not. By combining TLmean and SUVmax values, a 100% sensitivity can be achieved with acceptable specificity.

2014 ◽  
Vol 41 (9) ◽  
pp. 1756-1766 ◽  
Author(s):  
Benjapa Khiewvan ◽  
Homer A. Macapinlac ◽  
Dina Lev ◽  
Ian E. McCutcheon ◽  
John M. Slopis ◽  
...  

2021 ◽  
Author(s):  
Yoshihiro Nishida ◽  
Kunihiro Ikuta ◽  
Shinji Ito ◽  
Hiroshi Urakawa ◽  
Tomohisa Sakai ◽  
...  

2016 ◽  
Vol 45 (8) ◽  
pp. 1097-1105 ◽  
Author(s):  
Stephen M. Broski ◽  
Geoffrey B. Johnson ◽  
Benjamin M. Howe ◽  
Mark A. Nathan ◽  
Doris E. Wenger ◽  
...  

Neurology ◽  
2019 ◽  
Vol 93 (11) ◽  
pp. e1076-e1084 ◽  
Author(s):  
Shivani Ahlawat ◽  
Jaishri O. Blakeley ◽  
Fausto J. Rodriguez ◽  
Laura M. Fayad

ObjectiveTo determine the utility of quantitative metrics obtained from fMRI using diffusion-weighted imaging (DWI)/apparent diffusion coefficient (ADC) mapping compared with metabolic (18F-fluorodeoxyglucose [FDG]-PET/CT) imaging in patients with neurofibromatosis type 1 (NF1) for the characterization of peripheral nerve sheath tumors (PNSTs) as benign or malignant.MethodsThis Institutional Review Board–approved, Health Insurance Portability and Accountability Act–compliant study retrospectively reviewed imaging of 55 PNSTs in 21 patients with NF1. Imaging included anatomic (unenhanced T1, fluid-sensitive, contrast-enhanced T1-weighted), functional DWI (b = 50, 400, 800 s/mm2) and ADC mapping, magnetic resonance sequences, and FDG-PET/CT imaging. Anatomic (size), functional (minimum ADC values), and metabolic (maximum standardized uptake values [SUVmax]) imaging characteristics were recorded. ADC values were correlated with SUVmax. With histologic correlation for all malignant PNSTs (MPNSTs) or clinical or imaging stability (>12 months) for benign lesions used as reference standards, diagnostic accuracy was calculated.ResultsOf 55 PNSTs, there were 19 (35%) malignant and 36 (65%) benign PNSTs. Benign PNSTs were overall smaller than MPNSTs (largest diameter 4.3 ± 1.3 vs 8.2 ± 3.3 cm, respectively, p = 0.014). Benign PNSTs had higher ADCmin (×10−3 mm2/s) than MPNSTs (1.6 ± 0.4 vs 0.6 ± 0.2, respectively, p < 0.0001) and lower SUVmax than MPNSTs (3.2 ± 1.8 vs 8 ± 3.9, p < 0.0001, respectively). ADCmin correlated inversely with SUVmax (correlation coefficient r = −0.0.58, p < 0.0001). Maintaining a sensitivity of 100% with threshold values of ADCmin ≤1 or SUVmax >3.2, DWI yielded a specificity of 94% while FDG-PET/CT offered a specificity of 83%.ConclusionsBoth quantitative metabolic imaging and functional imaging offer high sensitivity for the characterization of PNSTs in NF1; however, DWI/ADC mapping offers increased specificity and may be a more useful modality.Classification of evidenceThis study provides Class II evidence that for patients with NF1, MRI using DWI/ADC mapping accurately distinguishes malignant and benign PNSTs.


2020 ◽  
Vol 36 (6) ◽  
pp. 967.e17-967.e19
Author(s):  
Simone Cristina Soares Brandão ◽  
Luca Terracini Dompieri ◽  
Romero Carlos Tonini ◽  
Petherson Susano Grativvol ◽  
Juliano Dallapicula Gama ◽  
...  

2013 ◽  
Vol 38 (1) ◽  
pp. e19-e25 ◽  
Author(s):  
Thorsten Derlin ◽  
Katharina Tornquist ◽  
Silvia Münster ◽  
Ivayla Apostolova ◽  
Christian Hagel ◽  
...  

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