Mhm. Schwarzbach et al., Clinical value of [18-F] fluorodeoxyglucose positron emission tomography imaging in soft tissue sarcomas, ANN SURG, 231(3), 2000, pp. 380-386
Objective
To evaluate positron emission tomography (PET) using 2-fluoro-2-deoxy-D-glu
cose (FDG) for clinical application in soft tissue sarcomas.
Summary and Background Data
FDG PET is a promising noninvasive method for the preoperative assessment o
f soft tissue sarcomas and may complement radiologic tomography.
Methods
Data from 50 consecutive patients with 59 masses, either suspicious for pri
mary or locally recurrent soft tissue sarcoma, were prospectively gathered.
The semiquantitative FDG uptake (standardized uptake values [SUVs]) was ca
lculated in tumor and normal tissue (muscle). Histopathology of surgical sp
ecimens and follow-up data were used as control criteria.
Results
In primary soft tissue sarcomas, PET displayed a sensitivity of 91% and a s
pecificity of 88%. Local recurrence was detected with a sensitivity of 88%
and a specificity of 92%, All intermediate-grade and high-grade soft tissue
sarcomas (primary and locally recurrent) were Visualized with a precise di
fferentiation from muscle, Fifty percent of the low-grade sarcomas showed a
n FDG uptake equivalent to muscle (false-negative results in one primary an
d three recurrent soft tissue sarcomas). Benign soft tissue tumors (e.g., l
ipoma, leiomyoma, ganglion) did not accumulate FDG. inflammation resulted i
n an increased FDG uptake. The semiquantitative FDG uptake (SUVs) correlate
d with tumor grade but not with size and histologic type.
Conclusion
High-grade and intermediate-grade soft tissue sarcomas are amenable to PET
imaging, whereas low-grade lesions may not be depicted, SUVs for FDG correl
ate with tumor grade in soft tissue sarcomas, Benign soft tissue tumors are
differentiated from higher-grade soft tissue sarcomas. These data show tha
t FDG-PET can complement preoperative radiologic assessment for soft tissue
sarcomas and that FDG-PET is a powerful diagnostic toot for detecting high
-grade and intermediate-grade local recurrence.