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Diagnostic Applications of Nuclear Medicine: Sarcomas

Nuclear Oncology

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Abstract

Bone and soft tissue tumors, while rare, account for a relatively large proportion of pediatric cancer diagnoses. The role for [18F]FDG PET/CT in the staging and prognostication of pediatric s arcomas remains an active area for research and topic of debate. [18F]FDG PET/CT clearly maintains a significant role in the detection of osseous metastasis in osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma; however, it lacks the sensitivity and specificity in detecting pulmonary metastasis when compared to conventional CT scan. [18F]FDG PET/CT predicts histologic response in osteosarcoma; however, more studies are needed to determine whether it can predict outcome in other pediatric sarcomas as a whole. While [18F]FDG PET/CT is becoming increasingly utilized in the staging of pediatric sarcomas, more research will be needed to fully understand how best to incorporate its use in the management of, or as a prognostic tool in, pediatric and young adult bone and soft tissue sarcomas.

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Abbreviations

ADC:

Apparent diffusion coefficient, an imaging parameter employed with MRI

AYA:

Adolescent and young adult patient populations

BS:

Bone scintigraphy with 99mTc-diphosphonates

CIMs:

Conventional imaging modalities, including ultrasonography, plain X-ray, CT, MRI (and BS in some studies)

CMR:

Complete metabolic response on [18F]FDG PET/CT

COG:

Children’s Oncology Group

CT:

X-ray-based computed tomography

ctDNA:

Circulating tumor DNA

DFS:

Disease-free survival

DSRCT:

Desmoplastic small round cell tumor

EFS:

Event-free survival

ES:

Ewing sarcoma

[18F]FDG:

2-Deoxy-2-[18F]fluoro-d-glucose

HR:

Hazard ratio

LRFS:

Local relapse-free survival

MIP:

Maximum intensity projection image

MPNST:

Malignant peripheral nerve sheath tumor

MRI:

Magnetic resonance imaging

MTV:

Metabolic tumor volume as evaluated with [18F]FDG PET/CT

NF-1:

Neurofibromatosis type-1

NOS:

Not otherwise specified

NRSTS:

Non-rhabdomyosarcoma soft tissue sarcomas

OS:

Overall survival

PET:

Positron emission tomography

PET/CT:

Positron emission tomography/computed tomography

PFS:

Progression-free survival

ROC:

Receiver operating characteristic, a type of statistical analysis yielding a graphical plot that illustrates the diagnostic ability of a binary classifier system based on a certain discrimination threshold

SUV:

Standardized uptake value

SUVmax:

Standardized uptake value at the point/voxel of maximum uptake

SUVmean:

Average SUV in a certain whole volume of interest

SUVpeak:

SUV estimated within a small, fixed-size region of interest (ROIpeak) centered on a high-uptake part of the volume of interest

TLG:

Total lesion glycolysis

TNM:

Classification of tumors according to status of the primary tumor (T), loco-regional lymph nodes (N), and distant metastases (M)

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Authors and Affiliations

  1. Division of Pediatrics, Unit 87, MD Anderson Cancer Center, Houston, TX, USA

    Sumit Gupta & Douglas J. Harrison

  2. Department of Radiology, Seattle Children’s Hospital, Seattle, WA, USA

    Marguerite T. Parisi

  3. Diagnostic Imaging, Saint Jude Children’s Research Hospital, Memphis, TN, USA

    Barry L. Shulkin

Authors
  1. Sumit Gupta
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  2. Douglas J. Harrison
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  4. Barry L. Shulkin
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Correspondence to Barry L. Shulkin .

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Editors and Affiliations

  1. Associate Professor and Director of Nuclear Medicine, University of Pisa, Pisa, Italy

    Duccio Volterrani

  2. Translational Research, Pisa University, PISA, Pisa, Italy

    Paola A. Erba

  3. Attending Emeritus, Memorial Sloan-Kettering Cancer Center Dept. Radiology, New York, NY, USA

    H. William Strauss

  4. Professor Emeritus, University of Pisa, Pisa, Italy

    Giuliano Mariani

  5. Attending Physician, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Steven M. Larson

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Gupta, S., Harrison, D.J., Parisi, M.T., Shulkin, B.L. (2022). Diagnostic Applications of Nuclear Medicine: Sarcomas. In: Volterrani, D., Erba, P.A., Strauss, H.W., Mariani, G., Larson, S.M. (eds) Nuclear Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-26067-9_92-2

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  • DOI: https://doi.org/10.1007/978-3-319-26067-9_92-2

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  1. Latest

    Diagnostic Applications of Nuclear Medicine: Sarcomas
    Published:
    20 May 2022

    DOI: https://doi.org/10.1007/978-3-319-26067-9_92-2

  2. Original

    Diagnostic Applications of Nuclear Medicine: Sarcomas
    Published:
    10 April 2022

    DOI: https://doi.org/10.1007/978-3-319-26067-9_92-1

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