The usefulness of 18-F-FDG PET/CT for detection of adult soft tissue sarcomas local recurrence and distant metastases

10583 Background: Surrogate endpoints for survival are needed to allow rapid assessment of new therapies without doing lengthy studies using a survival endpoint. Non-invasive assessment of treatment response is also needed to guide chemotherapy. FDG- PET-CT has potential for assessing response to treatment in sarcoma. This study's goal was to correlate FDG-PET-CT, along with standard CT, with histologic response after chemotherapy for high grade soft tissue sarcomas before resection. Methods: Patients with high grade soft tissue sarcomas > 5 cm were enrolled in a prospective clinical trial and given ifosfamide/doxorubicin before tumor excision. FDG-PET-CT was performed at baseline before treatment, after cycle 1, & just before surgery. Differences in both SUVmax (baseline to cycle 1 [B-1], baseline to surgery [B-3]) and CT criteria (RECIST 1 dimension [1D], RECIST 2D & Choi) were compared to histologic response (> or < 90%) upon excision. Results: 25 patients were enrolled and 4 had disease progression prior to completing all 3 PET-CT's yielding 21 evaluable cases. 5 patients had SUVmax change of <40%: 4/5 (80%) had histologic response < 90% & 1/5 (20%) had histologic response >90%. 16 patients had SUVmax change of >40%: 12/16 (75%) had histologic response >90% & 4/16 (25%) had histologic response <90%. A scatterplot of SUVmax change (baseline to surgery), & histologic response as continuous variables revealed a Spearman's correlation coefficient = 0.55 (p<0.01). Conclusions: A cutoff value of 40% reduction in SUVmax from baseline to surgery appeared to differentiate histologic responders. Using this to define PET response, a correlation between PET response, as well as RECIST 1D and 2D, and histologic response was observed. Additional patient follow-up & further study of FDG-PET-CT as a surrogate endpoint for histologic response and survival is warranted. [Table: see text] [Table: see text]

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Value of FDG PET/CT in Patient Management and Outcome of Skeletal and Soft Tissue Sarcomas

PET Clinics ◽

10.1016/j.cpet.2015.03.003 ◽

2015 ◽

Vol 10 (3) ◽

pp. 375-393 ◽

Cited By ~ 20

Author(s):

Sara Sheikhbahaei ◽

Charles Marcus ◽

Nima Hafezi-Nejad ◽

Mehdi Taghipour ◽

Rathan M. Subramaniam

Keyword(s):

Soft Tissue ◽

Fdg Pet ◽

Patient Management ◽

Soft Tissue Sarcomas ◽

Pet Ct ◽

Fdg Pet Ct

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Change in quantitative FDG-PET was significantly more accurate than change in size at predicting histopathologic response to neoadjuvant therapy in high grade soft tissue sarcomas

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.10017 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 10017-10017

Author(s):

V. Evilevitch ◽

W. A. Weber ◽

W. D. Tap ◽

K. Chow ◽

M. Allen-Auerbach ◽

...

Keyword(s):

Soft Tissue ◽

Neoadjuvant Therapy ◽

Tumor Size ◽

Fdg Pet ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Fdg Uptake ◽

Histopathologic Response ◽

Pet Ct ◽

Fdg Pet Ct

10017 Background: Change in size by RECIST (Response Evaluation Criteria in Solid Tumors) has been the standard to assess response to therapy in non-GIST soft tissue sarcomas (STS). Although recent studies have demonstrated that Positron Emission Tomography with F18-fluorodeoxyglucose (FDG-PET) may be used to assess response, there has not been a direct comparison between these modalities. The aim of this study was to prospectively evaluate whether a change in quantitative FDG-PET or a change in size [computed tomography(CT)] was more accurate at predicting histopathologic response to neoadjuvant therapy in patients with high grade STS using a combined FDG-PET/CT scan. Methods: From 1/05 - 12/06 58 patients with resectable biopsy proven high grade STS scheduled to undergo neoadjuvant chemotherapy were prospectively enrolled in this study. Patients underwent FDG-PET/CT prior to and after neoadjuvant treatment (prior to surgery). Tumor FDG-uptake was quantified by standardized uptake values (SUV). Changes in tumor size were quantified according to RECIST. Following tumor resection, response was assessed histopathologically. Patients with = 10% viable tumor cells were classified as responders. To date, 36 patients have completed the study and are the subject of this analysis. Results: In histopathologic responders (n=10, 28%), reduction of tumor FDG-uptake was significantly greater (-64%) than in histopathologic non-responders (-37%), (p=0.005). Using a 50% decrease in tumor SUV as a threshold value resulted in a sensitivity of 90% and a specificity of 58% for assessment of histopathologic response (p=0.01). Response assessment per RECIST showed no significant correlation with histopathologic response (sensitivity 20%, specificity 89%, p=0.4). There was no correlation between changes in tumor size and histopathologic response (area under the ROC curve = 0.6, p=0.1). Conclusions: In patients with high grade STS, quantitative FDG-PET was significantly more accurate than size based criteria for assessment of histopathologic response to neoadjuvant therapy. FDG-PET should be considered as a modality to monitor treatment response is patients with high grade STS. No significant financial relationships to disclose.

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Inferior glucose metabolism and chemosensitivity of post-radiotherapy local recurrence in comparison with distant metastases as assessed by serial 18F-FDG PET/CT imaging.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.15_suppl.e21004 ◽

2011 ◽

Vol 29 (15_suppl) ◽

pp. e21004-e21004

Author(s):

L. Xing ◽

X. Sun ◽

C. Liu ◽

X. Sun ◽

J. Yu

Keyword(s):

Glucose Metabolism ◽

Local Recurrence ◽

Fdg Pet ◽

Distant Metastases ◽

Ct Imaging ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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FDG-PET/CT Imaging Predicts Histopathologic Treatment Responses after the Initial Cycle of Neoadjuvant Chemotherapy in High-Grade Soft-Tissue Sarcomas

Clinical Cancer Research ◽

10.1158/1078-0432.ccr-08-2537 ◽

2009 ◽

Vol 15 (8) ◽

pp. 2856-2863 ◽

Cited By ~ 118

Author(s):

Matthias R. Benz ◽

Johannes Czernin ◽

Martin S. Allen-Auerbach ◽

William D. Tap ◽

Sarah M. Dry ◽

...

Keyword(s):

Soft Tissue ◽

Neoadjuvant Chemotherapy ◽

Fdg Pet ◽

Soft Tissue Sarcomas ◽

Ct Imaging ◽

High Grade ◽

Pet Ct ◽

Treatment Responses ◽

Fdg Pet Ct ◽

Initial Cycle

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Correlating Metabolic Activity on18F-FDG PET/CT With Histopathologic Characteristics of Osseous and Soft-Tissue Sarcomas: A Retrospective Review of 136 Patients

American Journal of Roentgenology ◽

10.2214/ajr.11.7560 ◽

2012 ◽

Vol 198 (6) ◽

pp. 1409-1416 ◽

Cited By ~ 45

Author(s):

Rajan Rakheja ◽

William Makis ◽

Sonia Skamene ◽

Ayoub Nahal ◽

Fadi Brimo ◽

...

Keyword(s):

Soft Tissue ◽

Metabolic Activity ◽

Retrospective Review ◽

Fdg Pet ◽

Soft Tissue Sarcomas ◽

Pet Ct ◽

Fdg Pet Ct

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Diagnostic and Clinical Impact of 18F-FDG PET/CT in Staging and Restaging Soft-Tissue Sarcomas of the Extremities and Trunk: Mono-Institutional Retrospective Study of a Sarcoma Referral Center

Journal of Clinical Medicine ◽

10.3390/jcm9082549 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2549

Author(s):

Alessio Annovazzi ◽

Sandra Rea ◽

Carmine Zoccali ◽

Rosa Sciuto ◽

Jacopo Baldi ◽

...

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Fdg Pet ◽

Soft Tissue Sarcomas ◽

Emission Computed Tomography ◽

Therapy Planning ◽

Histologic Subtype ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Background: Soft-tissue sarcomas (STS) represent a wide heterogeneous class of rare tumors. The exact role 18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT) in the evaluation of STS is not well established. The aim of the present study was to evaluate how the use of 18F-FDG PET/CT in STS could influence patient therapy planning, looking for a possible added value over computed tomography and magnetic resonance imaging—the most used modalities in the study of STS. Differences in SUVmax according to histologic subtype and tumor grade were also considered. Methods: a total of 345 consecutive 18F-FDG PET/CT scans performed for initial staging (n = 171) or for suspected disease relapse (n = 174) in 282 patients with STS extracted from the local Information System database were retrospectively reviewed. Results: 18F-FDG PET/CT altered therapy planning in 80 cases (16.4% for staging and 29.9% in restaging), both for disease upstaging (58.8%) and downstaging (41.2%) Conclusions: 18F-FDG PET/CT could significantly influence management of patients with STS, particularly for restaging.

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Soft tissue metastases from differentiated thyroid cancer diagnosed by 18F FDG PET-CT

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302013000400007 ◽

2013 ◽

Vol 57 (4) ◽

pp. 317-321 ◽

Cited By ~ 5

Author(s):

Inés Califano ◽

Sergio Quildrian ◽

Martín Coduti ◽

Erica Rojas Bilbao ◽

José Otero ◽

...

Keyword(s):

Thyroid Cancer ◽

Soft Tissue ◽

Fdg Pet ◽

Differentiated Thyroid Cancer ◽

Soft Tissues ◽

Distant Metastases ◽

The Body ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluordeoxyglucose positron emission tomography/computed tomography (18F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of 18F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored.

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