Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Feb;241(2):286-94.
doi: 10.1097/01.sla.0000152663.61348.6f.

Prognostic significance of preoperative [18-F] fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in patients with resectable soft tissue sarcomas

Matthias H M Schwarzbach  1 , Ulf Hinz, Antonia Dimitrakopoulou-Strauss, Frank Willeke, Servando Cardona, Gunhild Mechtersheimer, Thomas Lehnert, Ludwig G Strauss, Christian Herfarth, Markus W Büchler
Affiliations

Prognostic significance of preoperative [18-F] fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in patients with resectable soft tissue sarcomas

Matthias H M Schwarzbach et al. Ann Surg. 2005 Feb.

Abstract

Objective: The objective of this study was to evaluate the prognostic significance of preoperative positron emission tomography (PET) using 2-fluoro-2-deoxy-D-glucose (FDG) by calculating the mean standardized uptake values (SUV) in patients with resectable soft tissue sarcomas (STS).

Summary and background data: FDG-PET might be used as an adjunctive tool (in addition to biopsy and radiologic tomography) in the preoperative prognostic assessment of resectable STS.

Methods: A total of 74 adult patients with STS underwent preoperative FDG-PET imaging with calculation of the SUV. Clinicopathologic data and the SUV were analyzed for an association with the clinical outcome. The first and the third quartiles of the SUV distribution function were used as cutoff values (1.59 and 3.6). Survival was estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed using log-rank test and the Cox proportional hazards regression model.

Results: In 55 cases, STS were completely resected (follow up 40 months): 5-year recurrence-free survival rates in patients with SUV <1.59, 1.59 to <3.6, and > or =3.6 were 66%, 24%, and 11%, respectively (P = 0.0034). SUV was a predictor for overall survival (5-year rates: 84% [SUV <1.59], 45% [SUV 1.59 to <3.6], and 38% [SUV > or =3.6]; P = 0.057) and local tumor control (5-year rates: 93% [SUV <1.59], 43% [SUV 1.59 to <3.6], and 15% [SUV > or =3.6]; P = 0.0017). By multivariate analysis, SUV was found to be predictive for recurrence-free survival. The prognostic differences with respect to the SUV were associated with tumor grade (P = 0.002).

Conclusion: The semiquantitative FDG uptake, as measured by the mean SUV on preoperative PET images in patients with resectable STS, is a useful prognostic parameter. SUV with cutoff values at the first and the third quartiles of the SUV distribution predicted overall survival, recurrence-free survival, and local tumor control. Therefore, FDG-PET can be used to improve the preoperative prognostic assessment in patients with resectable STS.

PubMed Disclaimer

Figures

None
FIGURE 1. Overall survival distribution function stratified by extent of operation (complete resection with microscopically negative and positive margin, incomplete resection, and exploration/biopsy) of 74 patients with soft tissue sarcomas.
None
FIGURE 2. Recurrence-free survival distribution function stratified by the mean standardized uptake value (SUV). Preoperative SUV <1.59 versus preoperative SUV 1.59 to <3.6 versus preoperative SUV ≥3.6 in 55 patients treated by complete resection of soft tissue sarcomas.
None
FIGURE 3. Overall survival distribution function stratified by the mean standardized uptake value (SUV). Preoperative SUV <1.59 versus preoperative SUV 1.59 to <3.6 versus preoperative SUV ≥3.6 in 55 patients treated by complete resection of soft tissue sarcomas.
None
FIGURE 4. Local tumor control stratified by the mean standardized uptake value (SUV). Preoperative SUV <1.59 versus preoperative SUV 1.59 to <3.6 versus preoperative SUV ≥3.6 in 55 patients treated by complete resection of soft tissue sarcomas.
See this image and copyright information in PMC

References

    1. Frassica FJ, Khanna JA, McCarthy EF. The role of MR imaging in soft tissue tumor evaluation: perspective of the orthopedic oncologist and musculoskeletal pathologist. Magn Reson Imaging Clin North Am. 2000;8:915–927. - PubMed
    1. De Schepper AM, De Beuckeleer L, Vandevenne J, et al. Magnetic resonance imaging of soft tissue tumors. Eur Radiol. 2000;10:213–223. - PubMed
    1. Imaizumi S, Morita T, Ogose A, et al. Soft tissue sarcoma mimicking chronic hematoma: value of magnetic resonance imaging in differential diagnosis. J Orthop Sci. 2002;7:33–37. - PubMed
    1. Jones C, Liu K, Hirschowitz S, et al. Concordance of histopathologic and cytologic grading in musculoskeletal sarcomas: can grades obtained from analysis of the fine-needle aspirates serve as the basis for therapeutic decisions? Cancer. 2002;96:83–91. - PubMed
    1. Hoeber I, Spillane AJ, Fisher C, et al. Accuracy of biopsy techniques for limb and limb girdle soft tissue tumors. Ann Surg Oncol. 2001;8:80–87. - PubMed

Publication types

Substances