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The diagnostic and prognostic value of 18F-FDG PET/CT in the initial assessment of high-grade bone and soft tissue sarcoma. A retrospective study of 89 patients

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Abstract

Purpose

To evaluate the feasibility of 18F-FDG PET/CT for initial assessment in high-grade bone sarcomas (BS) and soft tissue sarcomas (STS).

Methods

During the years 2001–2010, 89 patients (30 BS, 59 STS) referred for further evaluation and surgical treatment of a high-grade BS or STS also had a PET/CT scan performed for staging preoperatively (n = 68) or within 1 month of surgery (n = 21). Metastatic lesions suggested on the PET/CT scan were confirmed or rejected by histological evaluation, by additional imaging or by follow-up. In 68 patients (28 BS, 40 STS) the relationship between the maximal standardized uptake value (SUVmax) of the primary tumour and survival was examined.

Results

The PET/CT scan suggested the presence of 13 metastatic lesions in BS patients (5 lymph node, 8 distant) and 21 metastatic lesions (6 lymph node, 15 distant) in STS patients. The calculated sensitivity (SE) and specificity (SP) were 95 % and 96 % for detection of distant metastases, and the predictive value (PV) of a positive or a negative test was 87 % and 98 %, respectively. SE and SP were 100 % and 90 % for detection of lymph node metastases, and the PV of a positive or a negative test was 27 % and 100 %, respectively. The 5-year survival was 81 % among patients with SUVmax below the median value (≤10), but was 33 % among those with SUVmax >10.

Conclusion

FDG PET/CT for the initial assessment of patients with high-grade BS or STS was feasible with high SE and SP, but in those with lymph node metastases the PV of a positive test was low. The SUVmax of the primary tumour was a strong prognostic factor for survival.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    Hanna Maria Fuglø, Dorrit Hovgaard & Michael M. Petersen

  2. Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Simon Møller Jørgensen & Annika Loft

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  1. Hanna Maria Fuglø
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  2. Simon Møller Jørgensen
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  3. Annika Loft
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  5. Michael M. Petersen
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Correspondence to Michael M. Petersen.

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Fuglø, H.M., Jørgensen, S.M., Loft, A. et al. The diagnostic and prognostic value of 18F-FDG PET/CT in the initial assessment of high-grade bone and soft tissue sarcoma. A retrospective study of 89 patients. Eur J Nucl Med Mol Imaging 39, 1416–1424 (2012). https://doi.org/10.1007/s00259-012-2159-z

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  • DOI: https://doi.org/10.1007/s00259-012-2159-z

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