Volume of interest delineation techniques for 18F-FDG PET-CT scans during neoadjuvant extremity soft tissue sarcoma treatment in adults: a feasibility study

Background: Prognostic biomarkers are pivotal for adequate treatment decision making. The objective of this study was to determine the added prognostic value of quantitative [18F]FDG-PET features in patients with metastases from soft tissue sarcoma (STS). Methods: Patients with metastases from STS, detected by (re)staging [18F]FDG-PET/CT at Leiden University Medical Centre, were retrospectively included. Clinical and histopathological patient characteristics and [18F]FDG-PET features (SUVmax, SUVpeak, SUVmean, total lesion glycolysis, and metabolic tumor volume) were analyzed as prognostic factors for overall survival using a Cox proportional hazards model and Kaplan–Meier methods. Results: A total of 31 patients were included. SUVmax and SUVpeak were significantly predictive for overall survival (OS) in a univariate analysis (p = 0.004 and p = 0.006, respectively). Hazard ratios (HRs) were 1.16 per unit increase for SUVmax and 1.20 per unit for SUVpeak. SUVmax and SUVpeak remained significant predictors for overall survival after correction for the two strongest predictive clinical characteristics (number of lesions and performance status) in a multivariate analysis (p = 0.02 for both). Median SUVmax and SUVpeak were 5.7 and 4.9 g/mL, respectively. The estimated mean overall survival in patients with SUVmax > 5.7 g/mL was 14 months; otherwise, it was 39 months (p < 0.001). For patients with SUVpeak > 4.9 g/mL, the estimated mean overall survival was 18 months; otherwise, it was 33 months (p = 0.04). Conclusions: In this study, SUVmax and SUVpeak were independent prognostic factors for overall survival in patients with metastases from STS. These results warrant further investigation of metabolic imaging with [18F]FDG-PET/CT in patients with metastatic STS.

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[18F]FDG PET/CT quantitative parameters for the prediction of histological response to induction chemotherapy and clinical outcome in patients with localised bone and soft-tissue Ewing sarcoma

European Radiology ◽

10.1007/s00330-021-07841-w ◽

2021 ◽

Author(s):

Alessio Annovazzi ◽

Virginia Ferraresi ◽

Vincenzo Anelli ◽

Renato Covello ◽

Sabrina Vari ◽

...

Keyword(s):

Soft Tissue ◽

Clinical Outcome ◽

Induction Chemotherapy ◽

Ewing Sarcoma ◽

Fdg Pet ◽

Histological Response ◽

Quantitative Parameters ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

Archives of Endocrinology and Metabolism ◽

10.20945/2359-3997000000063 ◽

2018 ◽

Vol 62 (4) ◽

pp. 460-465

Author(s):

Filiz Eksi Haydardedeoglu ◽

Gulay Simsek Bagir ◽

Nese Torun ◽

Emrah Kocer ◽

Mehmet Reyhan ◽

...

Keyword(s):

Fdg Pet ◽

Thyroid Nodules ◽

Hounsfield Unit ◽

Ct Scans ◽

Null Effect ◽

Unit Value ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Neoadjuvant Pazopanib Treatment in High-Risk Soft Tissue Sarcoma: A Quantitative Dynamic 18F-FDG PET/CT Study of the German Interdisciplinary Sarcoma Group

Cancers ◽

10.3390/cancers11060790 ◽

2019 ◽

Vol 11 (6) ◽

pp. 790 ◽

Cited By ~ 5

Author(s):

Christos Sachpekidis ◽

Ioannis Karampinis ◽

Jens Jakob ◽

Bernd Kasper ◽

Kai Nowak ◽

...

Keyword(s):

High Risk ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Kinetic Analysis ◽

Quantitative Evaluation ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Pet Ct ◽

18F Fdg ◽

Regression Grade

The outcome of high-risk soft tissue sarcoma (STS) is poor with radical surgery being the only potentially curative modality. Pazopanib is a multikinase inhibitor approved for the treatment of metastatic STS. Herein, in terms of the German Interdisciplinary Sarcoma Group (GISG-04/NOPASS) trial, we evaluate the potential role of kinetic analysis of fludeoxyglucose F-18 (18F-FDG) data derived from the application of dynamic positron emission tomography/computed tomography (PET/CT) in response assessment to pazopanib of STS patients scheduled for surgical resection. Sixteen STS patients treated with pazopanib as neoadjuvant therapy before surgery were enrolled in the analysis. All patients underwent dynamic PET/CT prior to and after pazopanib treatment. Data analysis consisted of visual (qualitative) analysis of the PET/CT scans, semi-quantitative evaluation based on standardized uptake value (SUV) calculations, and quantitative analysis of the dynamic 18F-FDG PET data, based on two-tissue compartment modeling. Resection specimens were histopathologically assessed and the percentage of regression grade was recorded in 14/16 patients. Time to tumor relapse/progression was also calculated. In the follow-up, 12/16 patients (75%) were alive without relapse, while four patients (25%) relapsed, among them one patient died. Median histopathological regression was 20% (mean 26%, range 5–70%). The studied population was dichotomized using a histopathological regression grade of 20% as cut-off. Based on this threshold, 10/14 patients (71%) showed partial remission (PR), while stable disease (SD) was seen in the rest 4 evaluable patients (29%). Semi-quantitative evaluation showed no statistically significant change in the widely used PET parameters, SUVaverage and SUVmax. On the other hand, 18F-FDG kinetic analysis revealed a significant decrease in the perfusion-related parameter K1, which reflects the carrier-mediated transport of 18F-FDG from plasma to tumor. This decrease can be considered as a marker in response to pazopanib in STS and could be due to the anti-angiogenic effect of the therapeutic agent.

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