European Journal of Nuclear Medicine

, Volume 26, Issue 6, pp 599–605

Fluorodeoxyglucose positron emission tomography of soft tissue tumours: is a non-invasive determination of biological activity possible?

  • Michael Schulte
  • Doris Brecht-Krauss
  • Berno Heymer
  • Albrecht Guhlmann
  • Erich Hartwig
  • Michael R. Sarkar
  • Christoph G. Diederichs
  • Markus Schultheiß
  • Jörg Kotzerke
  • Sven N. Reske
Original article

Abstract.

Since musculoskeletal tumours comprise a large heterogeneous group of entities with different biological behaviour, clinical diagnosis of such lesions can be very difficult. The aim of this prospective study was to assess the usefulness of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the non-invasive evaluation of soft tissue tumours. One hundred and two patients with suspected soft tissue neoplasms were investigated by FDG-PET. The uptake of FDG was evaluated semiquantitatively by determining the tumour to background ratio (TBR). All patients underwent biopsy, resulting in the histological detection of 39 high-grade sarcomas, 16 intermediate-grade sarcomas, 11 low-grade sarcomas, 25 benign tumours, 10 tumour-like lesions such as spontaneous myositis ossificans (n = 6) and one non-Hodgkin lymphoma. All lesions except for two lipomas disclosed an increased FDG uptake. Sarcomas showed significantly higher TBR values than latent or active benign lesions (P<0.001) and aggressive benign lesions (P<0.05). Using a TBR cut-off level of 3.0 for malignancy, sensitivity of FDG-PET was 97.0%, specificity 65.7% and accuracy 86.3%. From our data there are three main conclusions: (1) Except for patients with pseudotumoral myositis ossificans, lesions with a TBR >3 were sarcomas (91.7%) or aggressive benign tumours (8.3%). (2) Tumours with a TBR <1.5 were latent or active benign lesions, exclusively. (3) The group with intermediate TBR values (<3 and >1.5) comprised primarily latent or active benign lesions, but also four aggressive benign tumours and two low-grade sarcomas. Our data suggest that FDG-PET represents a useful tool for the evaluation of the biological activity of soft tissue neoplasms.

Key words: Soft tissue neoplasms Sarcoma Fluorodeoxyglucose 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • Michael Schulte
    • 1
  • Doris Brecht-Krauss
    • 2
  • Berno Heymer
    • 3
  • Albrecht Guhlmann
    • 2
  • Erich Hartwig
    • 1
  • Michael R. Sarkar
    • 1
  • Christoph G. Diederichs
    • 2
  • Markus Schultheiß
    • 1
  • Jörg Kotzerke
    • 2
  • Sven N. Reske
    • 2
  1. 1.Department of Trauma, Hand- and Reconstructive Surgery, University Hospital Ulm, GermanyDE
  2. 2.Department of Nuclear Medicine, University Hospital Ulm, GermanyDE
  3. 3.Department of Pathology, University Hospital Ulm, GermanyDE

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