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FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses

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Abstract

Objective

To evaluate the standardized uptake value (SUV) of [18F]2-deoxy-2-fluoro-d-glucose at positron emission tomography (FDG-PET) for preoperative differential diagnosis between benign and malignant soft tissue masses.

Design

One hundred and fourteen soft tissue masses (80 benign, 34 malignant) were examined by FDG-PET prior to tissue diagnosis. The SUVs were calculated and compared between benign and malignant lesions and among different histologic subgroups which included three or more cases.

Results

There was a statistically significant difference in SUV between benign (1.80±1.42 [SD]) and malignant (4.20±3.16) soft tissue masses in total (P<0.0001). However, a considerable overlap in SUV was observed between many benign and malignant lesions. Liposarcomas (2.16±1.72) and synovial sarcomas (1.60±0.43) did not show significantly higher SUV than any benign lesions. Metastases (4.23±2.35) showed no statistically significant difference in SUV as compared with schwannomas (1.75±0.84), desmoids (2.77±1.32), sarcoidosis (3.62±1.53), or giant cell tumors of tendon sheath (GCT of TS; 5.06±1.63). Even malignant fibrous histiocytomas (5.37±1.40) could not be differentiated from sarcoidosis or GCT of TS, based on the SUV.

Conclusions

A large accumulation of FDG can be observed in both benign and malignant histiocytic, fibroblastic, or neurogenic lesions. SUV at conventional FDG-PET is limited to differentiating benign from malignant soft tissue masses, when all kinds of histologic subtypes are included.

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Author notes

  1. M. Tokunaga

    Present address: Department of Radiology, Ohta General Hospital, Japan

Authors and Affiliations

  1. Department of Diagnostic Radiology, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Japan

    J. Aoki, M. Tokunaga, Y. Koyama, N. Sato & K. Endo

  2. Department of Orthopaedic Surgery, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Japan

    H. Watanabe, T. Shinozaki & K. Takagishi

  3. Department of Nuclear Medicine, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Japan

    K. Endo

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  1. J. Aoki
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  2. H. Watanabe
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  3. T. Shinozaki
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  4. K. Takagishi
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Correspondence to J. Aoki.

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Aoki, J., Watanabe, H., Shinozaki, T. et al. FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses. Skeletal Radiol 32, 133–138 (2003). https://doi.org/10.1007/s00256-002-0586-9

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  • DOI: https://doi.org/10.1007/s00256-002-0586-9

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