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Nonsurgical giant cell tumour of the tendon sheath or of the diffuse type: Are MRI or 18F-FDG PET/CT able to provide an accurate prediction of long-term outcome?

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Abstract

Purpose

To investigate whether MRI (RECIST 1.1, WHO criteria and the volumetric approach) or 18F-FDG PET/CT (PERCIST 1.0) are able to predict long-term outcome in nonsurgical patients with giant cell tumour of the tendon sheath or of the diffuse type (GCT-TS/DT).

Methods

Fifteen “nonsurgical” patients with a histological diagnosis of GCT-TS/DT were divided into two groups: symptomatic patients receiving targeted therapy and asymptomatic untreated patients. All 15 patients were evaluated by MRI of whom 10 were treated, and a subgroup of 7 patients were evaluated by PET/CT of whom 4 were treated. Early evolution was assessed according to MRI and PET/CT scans at baseline and during follow-up. Cohen’s kappa coefficient was used to evaluate the degree of agreement between PERCIST 1.0, RECIST 1.1, WHO criteria, volumetric approaches and the reference standard (long-term outcome, delay 505 ± 457 days). The response rate in symptomatic patients with GCT-TS/DT receiving targeted therapy was also assessed in a larger population that included additional patients obtained from a review of the literature.

Results

The kappa coefficients for agreement between RECIST/WHO/volumetric criteria and outcome (15 patients) were respectively: 0.35 (p = 0.06), 0.26 (p = 0.17) and 0.26 (p = 0.17). In the PET/CT subgroup (7 patients), PERCIST was in perfect agreement with the late symptomatic evolution (kappa = 1, p < 0.05). In the treated symptomatic group including the additional patients from the literature the response rates to targeted therapies according to late symptomatic assessment, and PERCIST and RECIST criteria were: 65 % (22/34), 77 % (10/13) and 26 % (10/39).

Conclusion

18F-FDG PET/CT with PERCIST is a promising approach to the prediction of the long-term outcome in GCT-TS/DT and may avoid unnecessary treatments, toxicity and costs. On MRI, WHO and volumetric approaches are not more effective than RECIST using the current thresholds.

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Abbreviations

BTV:

Biological Tumour Volume

CSF:

Colony Stimulating Factor

GCT-TS/DT:

Giant cell tumour of the tendon sheath or diffuse type

HISUV:

Heterogeneity Index of the SUV

PERCIST:

PET Response Criteria In Solid Tumors

RECIST:

Response Evaluation Criteria in Solid Tumors

SD-SUV:

Standard Deviation SUV

CoV:

Coefficient of variation

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Authors and Affiliations

  1. Department of Nuclear Medicine, IUCT-Oncopole/Institut Claudius Regaud, 31100, Toulouse, France

    Laurent Dercle, Cyril Jaudet, Lawrence Dierickx, Slimane Zerdoud & Frédéric Courbon

  2. Department of Medical Biophysics and Nuclear Medicine, Hebrew University Hadassah Medical Center, Ein Kerem, 91120, Jerusalem, Israel

    Roland Chisin

  3. Department of Radiology, Institut Gustave Roussy, 94805, Villejuif, France

    Laurent Dercle & Samy Ammari

  4. Department of Nuclear Medicine, Hôpital tenon, Hôpitaux Universitaires Est Parisien, 75020, Paris, France

    Quentin Gillebert

  5. Department of Biostatistics, Institut Claudius Regaud, 31052, Toulouse, France

    Monia Ouali

  6. Department of Clinical Research, Institut Claudius Regaud, 31052, Toulouse, France

    Jean-Pierre Delord

  7. Department of Nuclear Medicine, Institut Gustave Roussy, 94805, Villejuif, France

    Laurent Dercle & Martin Schlumberger

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  1. Laurent Dercle
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Correspondence to Laurent Dercle.

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Dercle, L., Chisin, R., Ammari, S. et al. Nonsurgical giant cell tumour of the tendon sheath or of the diffuse type: Are MRI or 18F-FDG PET/CT able to provide an accurate prediction of long-term outcome?. Eur J Nucl Med Mol Imaging 42, 397–408 (2015). https://doi.org/10.1007/s00259-014-2938-9

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  • DOI: https://doi.org/10.1007/s00259-014-2938-9

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