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01.08.2015 | Nuclear Medicine

Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence

verfasst von: Wolfgang P. Fendler, Rebecca P. Chalkidis, Harun Ilhan, Thomas Knösel, Ken Herrmann, Rolf D. Issels, Peter Bartenstein, Clemens C. Cyran, Lars H. Lindner, Marcus Hacker

Erschienen in: European Radiology | Ausgabe 8/2015

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ABSTRACT

Objectives

This study evaluates the diagnostic accuracy of SUV-based parameters derived from [¹⁸ F]-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in order to optimize non-invasive prediction of soft tissue tumour (STT) grade.

Methods

One hundred and twenty-nine lesions from 123 patients who underwent FDG-PET for primary staging (n = 79) or assessment of recurrence (n = 44) of STT were analyzed retrospectively. Histopathology was the reference standard for tumour grading. Absolute values and tumour-to-liver ratios of several standardized uptake value (SUV) parameters were correlated with tumour grading.

Results

At primary diagnosis SUV_max, SUV_peak, SUV_max/SUV_liver and SUV_peak/SUV_liver showed good correlation with tumour grade. SUV_peak (area under the receiver-operating-characteristic, AUC-ROC: 0.82) and SUV_peak/SUV_liver (AUC-ROC: 0.82) separated best between low grade (WHO intermediate, grade 1 sarcoma, and low risk gastrointestinal stromal tumours, GISTs) and high grade (grade 2/3 sarcoma and intermediate/high risk GISTs) lesions: optimal threshold for SUV_peak/SUV_liver was 2.4, which resulted in a sensitivity of 79 % and a specificity of 81 %. At disease recurrence, the AUC-ROC was <0.75 for each parameter.

Conclusions

A tumour SUV_peak of at least 2.4 fold mean liver uptake predicts high grade histopathology with good diagnostic accuracy at primary staging. At disease recurrence, FDG-PET does not reliably separate high and low grade lesions.

Key Points

• Several SUV parameters accurately predict soft tissue sarcoma grade at primary diagnosis.

• Tumour-to-liver ratios are of comparable value to absolute SUV parameters.

• SUV _peak/SUV _liver >2.4 had 79 % sensitivity and 81 % specificity for high grade lesions.

• At recurrence, FDG PET does not reliably indicate high grade sarcomas.

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Titel: Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence
verfasst von: Wolfgang P. Fendler
Rebecca P. Chalkidis
Harun Ilhan
Thomas Knösel
Ken Herrmann
Rolf D. Issels
Peter Bartenstein
Clemens C. Cyran
Lars H. Lindner
Marcus Hacker
Publikationsdatum: 01.08.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3654-y

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Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence