Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

This study assessed the role of 18F-FDG PET-CT (PET/CT) to detect the cartilage and paraglottic infiltration in advanced glottic cancer comparing the results with those of conventional imaging (CI) (contrast-enhanced computed tomography and/or magnetic resonance). In addition, we assessed the prognostic value of quantitative parameters, measured on baseline PET/CT, in terms of event-free survival (EFS) and overall survival (OS). We retrospectively analyzed 27 patients with glottic squamous cell carcinoma stage III and IVA, treated in our institute between 2010 and 2016, comparing PET/CT, performed for staging and radiotherapy planning, and CI findings. Cohen’s K was used to compare concordance between PET/CT and CI. Imaging findings were correlated with endoscopic evaluation and histological reports (gold standard (GS)). All lesions shown by CI were also detected by PET/CT imaging, and in 5 cases, a better definition of local infiltration was achieved with PET/CT than CI (5 CT). Sensitivity, specificity, and accuracy of PET/CT and CT were 95%, 86%, and 93% and 70%, 86%, and 74% for, respectively. MRI showed sensitivity and specificity of 100%. One false-negative (FN) cases and 1 false-positive (FP) case were observed with PET/CT with no difference compared to MRI (10 cases). Six FN cases and 1 FP case were observed with CT. Cohen’s K was 0.60 (PET vs. CI) and 0.80 (PET vs. GS). Patients were followed-up for at least 24 months to calculate EFS and OS. 13 local recurrence and 7 deaths were recorded. Among quantitative PET parameters, baseline MTV was the most powerful predictor of outcome. Our data suggest a reliable sensitivity and accuracy of PET/CT in the evaluation of local extension, proving a useful method for initial local staging in addition to the well-established role in lymph-node and distant sites assessment. Furthermore, pretreatment MTV provides better prognostic information than other PET/CT parameters.

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The role of 18F-FDG PET/CT in soft tissue sarcoma

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001002 ◽

2019 ◽

Vol 40 (6) ◽

pp. 626-631 ◽

Cited By ~ 1

Author(s):

Andrea Sambri ◽

Giuseppe Bianchi ◽

Alessandra Longhi ◽

Alberto Righi ◽

Davide Maria Donati ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Fdg Pet ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Correlation of FDG PET-CT with histologic response after neoadjuvant chemotherapy for soft tissue sarcomas

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.10583 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 10583-10583

Author(s):

E. Y. Cheng ◽

J. W. Froelich ◽

J. C. Manivel ◽

B. J. Weigel ◽

K. M. Skubitz

Keyword(s):

Soft Tissue ◽

Fdg Pet ◽

Soft Tissue Sarcomas ◽

Response To Treatment ◽

Additional Patient ◽

High Grade ◽

Continuous Variables ◽

Histologic Response ◽

Pet Ct ◽

Fdg Pet Ct

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

10.21203/rs.3.rs-17726/v1 ◽

2020 ◽

Author(s):

Bo Chen ◽

Hongbo Feng ◽

Jinghui Xie ◽

Chun Li ◽

Yu Zhang ◽

...

Keyword(s):

Risk Factors ◽

Soft Tissue ◽

Regression Model ◽

Fdg Pet ◽

Univariate Analysis ◽

Ct Imaging ◽

Bone Lesions ◽

Benign Lesions ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background: Accurate differentiation between malignant and benign in soft tissue and bone lesions is essential for the prevention of excessive pathological biopsy and unplanned surgical resection. However, it remains a challenge and a standard diagnosis modality is urgently needed. The purpose of this study is to evaluate the usefulness of 18F- FDG PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions.Methods: Patients who underwent pretreatment 18F-FDG PET/CT imaging and subsequent biopsy to confirm malignant (STS and BS, n=37) and benign (n=33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and heterogeneous factor (HF) of each lesion were measured. Univariate analysis and multivariate logistic regression analysis were performed to screen the significant risk factors to distinguish STS and BS from benign lesions. To establish a regression model based on independent risk factors, receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performances.Results: Univariate analysis results showed that tumor size, SUVmax, MTV, TLG and HF of 18F-FDG PET/CT imaging in STS and BS group were all higher than benign lesions group, the difference were statistically significant (all P value were<0.01). However, the multivariate regression model only included SUVmax and HF as independent risk factors, odds radios were 1.135(95%CI: 1.026~1.256, P =0.014), 7.869(95%CI: 2.119~29.230, P =0.002), respectively. The regression model was as follow: Logit (P) = -2.461+0.127SUVmax+2.063HF. The area under the ROC was 0.860 (95%CI: 0.771~0.948, P <0.001) higher than SUVmax 0.744(95%CI: 0.628~0.860, P <0.001) and HF 0.790 (95%CI:0.684~0.896, P <0.001).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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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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