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The Role of 18F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma

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Abstract

Purpose

This research aims to investigate the potential of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET) to predict pathologic response after neoadjuvant chemotherapy (NAC) and overall survival (OS) of patients with synovial sarcoma in Korea.

Methods

Twenty patients with synovial sarcoma from January 2001 to December 2011 were reviewed retrospectively. All patients underwent pre-treatment FDG PET and tumor removal. Patients were classified with the maximum SUV (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), age, sex, histologic subtype, tumor size, NAC, resection margin, and metastasis at diagnosis. Pathologic response was assessed using the French Federation of Cancer Centers system. Statistical analyses were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards regression model, and Mann-Whitney test.

Results

Nine patients (45 %) showed pathologic response, and ten patients survived. Higher SUVmax, higher MTV, higher TLG, monophasic epithelial type, and metastasis at diagnosis were significantly related to poorer OS (p = 0.047, 0.016, 0.016, 0.045, and 0.018, respectively). By multivariate analysis, metastasis at diagnosis was significantly related to poorer OS (p = 0.012/HR = 5.9, 95 % CI 1.47 to 24.1). The SUVmax, MTV, and TLG of the non-responder group were significantly higher than those of the responder group (p = 0.020, 0.020, and 0.020, respectively). There was no significant difference in size between the two groups (p = 0.062).

Conclusions

A higher SUVmax on the pre-treatment scan, monophasic epithelial type, and metastasis at diagnosis were significantly associated with a poorer OS, and pathologic responders showed a higher SUVmax before NAC. The PET parameters can be used to predict OS and pathologic response in patients with synovial sarcomas before NAC.

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Acknowledgments

This work was supported by the Establishment of the Center for PET Application Technology Development, Korea Institute of Radiological and Medical Sciences (KIRAMS), and by grants from the Ministry of Education, Science and Technology (50441-2013).

Conflict of Interest

Kyoung Jin Chang, Ilhan Lim, Joon Yeun Park, A Ra Jo, Chang Bae Kong, Won Seok Song, Wan Hyeong Jo, Soo Yong Lee, Jae SooKoh, Byung Il Kim, Chang Woon Choi and Sang Moo Lim declare that they have no conflict of interest.

Ethical Statement

This study was approved by the ethics committee in our hospital and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons enrolled gave their informed consent prior to their inclusion in the study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul, 139-706, South Korea

    Kyoung Jin Chang, Ilhan Lim, Joon Yeun Park, A. Ra Jo, Byung Il Kim, Chang Woon Choi & Sang Moo Lim

  2. Department of Orthopedics, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea

    Chang Bae Kong, Won Seok Song, Wan Hyeong Jo & Soo Yong Lee

  3. Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea

    Jae Soo Koh

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  1. Kyoung Jin Chang
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Correspondence to Sang Moo Lim.

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Chang, K.J., Lim, I., Park, J.Y. et al. The Role of 18F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma. Nucl Med Mol Imaging 49, 33–41 (2015). https://doi.org/10.1007/s13139-014-0301-5

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  • DOI: https://doi.org/10.1007/s13139-014-0301-5

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