open access

Vol 19, No 1 (2016)
Original articles
Published online: 2016-01-29
Submitted: 2015-06-29
Accepted: 2015-09-10
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Dual-time point 18FDG-PET/CT imaging may be useful in assessing local recurrent disease in high grade bone and soft tissue sarcoma

Zhivka Dancheva, Pavel Bochev, Borislav Chaushev, Tsvetelina Yordanova, Aneliya Klisarova
DOI: 10.5603/NMR.2016.0005
·
Pubmed: 26841376
·
Nucl. Med. Rev 2016;19(1):22-27.

open access

Vol 19, No 1 (2016)
Original articles
Published online: 2016-01-29
Submitted: 2015-06-29
Accepted: 2015-09-10

Abstract

BACKGROUND: Sarcomas comprise 1% of malignant tumors in adults but represent a significant diagnostic and therapeutic challenge. Molecular imaging with 18FDG PET/CT is a powerful modality in oncology. Its use for initial assessment, evaluation of response to therapy and recurrent disease in most tumors is essential for therapeutic decisions. Its indication in sarcomas is still controversial. One of the indications for PET/CT in sarcomas is detection of recurrences. Nowadays magnetic resonance tomography (MRT) has a crucial role in identification of local recurrences in soft tissue and bone sarcoma. 18FDG-PET/CT may serve as a complementary method. Dual time point imaging (DTPI) has been studied for most tumors as a method for differentiating benign from malignant lesions. There is limited data on DTPI in sarcomas. Therefore we studied prospectively patients with suspected local recurrences in the treated area and used DTPI as a method for differentiating benign from malignant tissue.

The aim of this study was to evaluate the ability of dual-time point PET/CT to enhance sensitivity, specificity, PPV, NPV and accuracy of 18FDG PET/CT in high grade and low grade sarcomas.

MATERIAL AND METHODS: We conducted a dual-time PET/CT in 15 patients with suspected locally recurrent disease. The delayed scan was conducted on the 120th min in the suspected region. The interpretation of PET/CT was made both upon CT scan and metabolic scans. The percentage change over time per lesion was calculated (%DSUV). The increase in SUVmax with %DSUV > 10% in the late scanning was considered as indicative for malignancy. We assessed the sensitivity, specificity, accuracy, positive and negative predicting value of the interpretation of PET/CT at 60 min and 120 min. All of the patients were followed up for a period of 1–3 years after our examination, either with histologic results, or with an MRT scans.

RESULTS: The received sensitivity, specificity and accuracy of 18FDG PET/CT interpretation at 120 min in high grade sarcomas were respectively 100%, 80% and 89%. By comparison, in low grade tumors at 120 min scan, these parameters were 50%, 75% and 66%.

CONCLUSION: These preliminary data suggests that dual-time imaging in sarcomas improves sensitivity and accuracy in identification of local recurrent disease in high grade sarcomas and have limited role in low grade sarcomas. Further research is necessary to confirm these results.

Abstract

BACKGROUND: Sarcomas comprise 1% of malignant tumors in adults but represent a significant diagnostic and therapeutic challenge. Molecular imaging with 18FDG PET/CT is a powerful modality in oncology. Its use for initial assessment, evaluation of response to therapy and recurrent disease in most tumors is essential for therapeutic decisions. Its indication in sarcomas is still controversial. One of the indications for PET/CT in sarcomas is detection of recurrences. Nowadays magnetic resonance tomography (MRT) has a crucial role in identification of local recurrences in soft tissue and bone sarcoma. 18FDG-PET/CT may serve as a complementary method. Dual time point imaging (DTPI) has been studied for most tumors as a method for differentiating benign from malignant lesions. There is limited data on DTPI in sarcomas. Therefore we studied prospectively patients with suspected local recurrences in the treated area and used DTPI as a method for differentiating benign from malignant tissue.

The aim of this study was to evaluate the ability of dual-time point PET/CT to enhance sensitivity, specificity, PPV, NPV and accuracy of 18FDG PET/CT in high grade and low grade sarcomas.

MATERIAL AND METHODS: We conducted a dual-time PET/CT in 15 patients with suspected locally recurrent disease. The delayed scan was conducted on the 120th min in the suspected region. The interpretation of PET/CT was made both upon CT scan and metabolic scans. The percentage change over time per lesion was calculated (%DSUV). The increase in SUVmax with %DSUV > 10% in the late scanning was considered as indicative for malignancy. We assessed the sensitivity, specificity, accuracy, positive and negative predicting value of the interpretation of PET/CT at 60 min and 120 min. All of the patients were followed up for a period of 1–3 years after our examination, either with histologic results, or with an MRT scans.

RESULTS: The received sensitivity, specificity and accuracy of 18FDG PET/CT interpretation at 120 min in high grade sarcomas were respectively 100%, 80% and 89%. By comparison, in low grade tumors at 120 min scan, these parameters were 50%, 75% and 66%.

CONCLUSION: These preliminary data suggests that dual-time imaging in sarcomas improves sensitivity and accuracy in identification of local recurrent disease in high grade sarcomas and have limited role in low grade sarcomas. Further research is necessary to confirm these results.

Get Citation

Keywords

soft tissue, bone sarcomas, dual- time-point imaging, 18FDG-PET/CT, local recurrence

About this article
Title

Dual-time point 18FDG-PET/CT imaging may be useful in assessing local recurrent disease in high grade bone and soft tissue sarcoma

Journal

Nuclear Medicine Review

Issue

Vol 19, No 1 (2016)

Pages

22-27

Published online

2016-01-29

DOI

10.5603/NMR.2016.0005

Pubmed

26841376

Bibliographic record

Nucl. Med. Rev 2016;19(1):22-27.

Keywords

soft tissue
bone sarcomas
dual- time-point imaging
18FDG-PET/CT
local recurrence

Authors

Zhivka Dancheva
Pavel Bochev
Borislav Chaushev
Tsvetelina Yordanova
Aneliya Klisarova

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