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Diagnostic accuracy of 18F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic accuracy of 18F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma.

Methods

We retrospectively analysed data from 53 patients (age 20.1 ± 10.5 years, 39 male) who had undergone 71 18F-FDG PET/CT studies for suspected recurrence (52 studies) or for routine follow-up (19 studies) after primary therapy of skeletal Ewing sarcoma. 18F-FDG PET/CT studies were evaluated qualitatively and quantitatively (maximum standardized uptake value, SUVmax) by two nuclear medicine physicians in consensus. Sensitivity, specificity, predictive values and accuracy were calculated on per study basis. Clinical/imaging follow-up (minimum 6 months) and/or histopathology (when available) were taken as the reference standard.

Results

Of the total of 71 18F-FDG PET/CT studies, 42 (59.1 %) were positive for recurrence and 29 (40.9 %) were negative for recurrence. Local recurrence was most common (38 studies) followed by bone metastasis (9 studies), and node and lung metastasis (2 studies each). Of the 71 studies, 38 were true-positive, 27 were true-negative, 4 were false-positive and 2 were false-negative. Overall per study based sensitivity was 95 %, specificity was 87 %, PPV was 90 %, NPV was 93 % and accuracy was 91.5 %. No significant difference was found in the accuracy of PET/CT between the suspected recurrence group and the routine follow-up group (94 % vs. 84 %; P = 0.390). Overall mean lesion SUVmax was 7.8 ± 4.1 (range 1.9–17.2). No site-based difference was found in SUVmax.

Conclusion

18F-FDG PET/CT demonstrates high diagnostic accuracy for detecting recurrence in patients with primary skeletal Ewing sarcoma, when it is suspected (clinically or on imaging) or during routine follow-up.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029, India

    Punit Sharma, Bangkim Chandra Khangembam, K. C. Sudhir Suman, Harmandeep Singh, Chandrasekhar Bal, Arun Malhotra & Rakesh Kumar

  2. Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India

    Sishir Rastogi & Shah Alam Khan

  3. Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Sameer Bakhshi

  4. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

    Sanjay Thulkar

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  1. Punit Sharma
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  2. Bangkim Chandra Khangembam
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  11. Rakesh Kumar
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Correspondence to Rakesh Kumar.

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Sharma, P., Khangembam, B.C., Suman, K.C.S. et al. Diagnostic accuracy of 18F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma. Eur J Nucl Med Mol Imaging 40, 1036–1043 (2013). https://doi.org/10.1007/s00259-013-2388-9

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  • DOI: https://doi.org/10.1007/s00259-013-2388-9

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