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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.05.2013 | Original Article

Evaluation of intratumoural heterogeneity on ¹⁸F-FDG PET/CT for characterization of peripheral nerve sheath tumours in neurofibromatosis type 1

verfasst von: Johannes Salamon, Thorsten Derlin, Peter Bannas, Jasmin D. Busch, Jochen Herrmann, Maximilian Bockhorn, Christian Hagel, Reinhard E. Friedrich, Gerhard Adam, Victor F. Mautner

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2013

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Abstract

Purpose

The aim of the study was to evaluate the potential usefulness of intratumoural tracer uptake heterogeneity on ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT as compared to a cut-off maximum standardized uptake value (SUV_max) for characterization of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1).

Methods

Fifty patients suffering from NF1 were examined by ¹⁸F-FDG PET/CT. Intralesional tracer uptake was analysed qualitatively and semi-quantitatively by measuring the mean and maximum SUV. Uptake heterogeneity was graded qualitatively using a three-point scale and semi-quantitatively by calculating an SUV-based heterogeneity index (HI_SUV). Cohen’s κ was used to determine inter- and intra-rater agreement. Histopathological evaluation and clinical as well as radiological follow-up examinations served as the reference standards.

Results

A highly significant correlation between the degree of intratumoural uptake heterogeneity on ¹⁸F-FDG PET and malignant transformation of PNSTs was observed (p < 0.0001). Semi-quantitative HI_SUV was significantly higher in malignant PNSTs (MPNSTs) than in benign tumours (p = 0.0002). Both intralesional heterogeneity and SUV_max could be used to identify malignant tumours with a sensitivity of 100 %. Cohen’s κ was 0.86 for inter-rater agreement and 0.88 for intra-rater agreement on heterogeneity.

Conclusion

MPNSTs in patients with NF1 demonstrate considerable intratumoural uptake heterogeneity on ¹⁸F-FDG PET/CT. Assessment of tumour heterogeneity is highly reproducible. Both tumour heterogeneity and a cut-off SUV_max may be used to sensitively identify malignant PNSTs, but the specificity is higher for the latter. A combination of both methods leads to a non-significant improvement in diagnostic performance.

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Titel: Evaluation of intratumoural heterogeneity on 18F-FDG PET/CT for characterization of peripheral nerve sheath tumours in neurofibromatosis type 1
verfasst von: Johannes Salamon
Thorsten Derlin
Peter Bannas
Jasmin D. Busch
Jochen Herrmann
Maximilian Bockhorn
Christian Hagel
Reinhard E. Friedrich
Gerhard Adam
Victor F. Mautner
Publikationsdatum: 01.05.2013
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2013
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2314-6

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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