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PET/CT in Synovial Tumors and Tumor-Like Conditions

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Imaging of Synovial Tumors and Tumor-like Conditions

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Accurate differentiation between a benign or malignant tumor is crucial to define the best therapeutic strategy. Besides the confirmation of the diagnosis of a malignancy, it is essential to know the exact histology and grading of the primary tumor. Consequently, the approach to a patient with a mass suspicious of a malignancy usually starts with a biopsy. By identifying the most metabolically active portion of a tumor mass, 18F-FDG-PET-CT can guide biopsy toward the most aggressive zone.

In rheumatoid arthritis, 18F-FDG PET can be used to assess disease activity in the affected joints, to reveal extra-articular manifestations (e.g., subcutaneous rheumatoid nodule, vasculitis, rheumatoid lung disease, pericarditis, and pleuritis) and to monitor response to treatment. In case of other benign synovial masses, the role of 18F-FDG PET is rather limited.

In the diagnostic work up of sarcoma, the strength of 18F-FDG PET-CT lies in its ability to detect metastases outside the standard field-of-view of CT and MRI, and in the exclusion of disease in equivocal results on conventional imaging. With regard to treatment monitoring in sarcoma, 18F-FDG PET seems promising, with a good correlation between an early and significant decline in metabolic activity and response to therapy. Although further studies are necessary, recent studies suggest a role for the use of 18F-FDG PET for detection of local recurrence of STS, particularly when combining the metabolic information of PET and the excellent soft tissue contrast of MRI in an integrated 18F-FDG PET/MRI.

Additionally, 18F-FDG uptake in high grade sarcoma on pretreatment scan is an independent predictor for overall and disease-free survival.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium

    Sarah K. Ceyssens

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  1. Sarah K. Ceyssens
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Correspondence to Sarah K. Ceyssens .

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  1. Department of Radiology, AZ Sint-Maarten Mechelen, Mechelen, Belgium

    Filip M. Vanhoenacker

  2. Department of Radiology, MT Kassab Institute of Orthopaedics, Tunis, Tunisia

    Mohamed Fethi Ladeb

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Ceyssens, S.K. (2023). PET/CT in Synovial Tumors and Tumor-Like Conditions. In: Vanhoenacker, F.M., Ladeb, M.F. (eds) Imaging of Synovial Tumors and Tumor-like Conditions. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2023_421

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  • DOI: https://doi.org/10.1007/174_2023_421

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