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Original Article

18F-Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma

  1. Akram Al-Ibraheem MD1,2,
  2. Andreas K. Buck MD1,3,
  3. Matthias R. Benz MD4,
  4. Maximilian Rudert MD5,
  5. Ambros J. Beer MD1,
  6. Asem Mansour MD2,
  7. Kelsey L. Pomykala BSc4,
  8. Bernhard Haller PhD6,
  9. Hendrik Juenger MD7,
  10. Klemens Scheidhauer MD1,
  11. Markus Schwaiger MD1,
  12. Ken Herrmann MD1,4,†,*

Article first published online: 11 DEC 2012

DOI: 10.1002/cncr.27866

Issue

Cancer

Cancer

Volume 119, Issue 6, pages 1227–1234, 15 March 2013

Additional Information

How to Cite

Al-Ibraheem, A., Buck, A. K., Benz, M. R., Rudert, M., Beer, A. J., Mansour, A., Pomykala, K. L., Haller, B., Juenger, H., Scheidhauer, K., Schwaiger, M. and Herrmann, K. (2013), 18F-Fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma. Cancer, 119: 1227–1234. doi: 10.1002/cncr.27866

Author Information

  1. 1

    Department of Nuclear Medicine, Technische Universität München, Munich, Germany

  2. 2

    Department of Radiology and Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan

  3. 3

    Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany

  4. 4

    Ahmanson Translational Imaging Division, University of California-Los Angeles, Los Angeles, California

  5. 5

    Department of Orthopedics and Traumatology, Technische Universität München, Munich, Germany

  6. 6

    Institute of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany

  7. 7

    Department of Pediatrics, Technische Universität München, Munich, Germany

  1. †

    Fax: (011) 49-931-201-635000

*Department of Nuclear Medicine, Technische Universität München, Ismaningerstrasse 22, 81675 München, Germany

  1. †

    Fax: (011) 49-931-201-635000

Publication History

  1. Issue published online: 4 MAR 2013
  2. Article first published online: 11 DEC 2012
  3. Manuscript Accepted: 18 SEP 2012
  4. Manuscript Received: 27 AUG 2012

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Keywords:

  • hybrid imaging;
  • positron emission tomography/computed tomography;
  • 18F-fluorodeoxyglucose;
  • sarcoma;
  • recurrence

Abstract

BACKGROUND:

The clinical utility of modern hybrid imaging modalities for detecting recurrent bone or soft tissue sarcoma remains to be determined. In this report, the authors present a clinical study on the diagnostic accuracy and incremental value of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with a history of sarcoma who have clinically suspected disease recurrence.

METHODS:

Forty-three patients who had a history of bone or soft tissue sarcoma and had documented complete remission underwent 18F-FDG PET/CT. Image analysis was performed independently for 18F-FDG PET (n = 43) and for contrast-enhanced spiral CT (CE-CT) (n = 30) by 2 separate readers, whereas combined 18F-FDG PET/CT (n = 43) images were analyzed in consensus by both readers. Imaging findings were rated on a 5-point scale and finally were reported as malignant, benign, or equivocal. Imaging findings were validated either by histopathology (n = 24) or by clinical follow-up (n = 19).

RESULTS:

18F-FDG PET/CT had greater sensitivity and specificity compared with CE-CT alone (94% and 92% vs 78% and 67%, respectively), resulting in significantly greater accuracy (93% vs 73%; P = .03). 18F-FDG PET/CT was particularly superior regarding detection of local recurrence or soft tissue lesions (sensitivity and specificity: 83% and 100% vs 50% and 100%, respectively) or bone metastases (100% and 100% vs 85% and 88%, respectively).

CONCLUSIONS:

18F-FDG PET/CT had greater diagnostic accuracy in the detection of recurrent bone or soft tissue sarcoma compared with CE-CT alone. The detection of local recurrence was the most evident advantage of 18F-FDG PET/CT over CE-CT. Cancer 2013. © 2012 American Cancer Society.

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