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

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 12...

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Published in:European Radiology Vol. 25; no. 8; pp. 2214 - 2222
Main Authors: Fendler, Wolfgang P, Chalkidis, Rebecca P, Ilhan, Harun, Knösel, Thomas, Herrmann, Ken, Issels, Rolf D, Bartenstein, Peter, Cyran, Clemens C, Lindner, Lars H, Hacker, Marcus
Format: research Journal Article
Published: Springer Nature Aug2015
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence.
      aug:
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          Fendler, Wolfgang P
          Chalkidis, Rebecca P
          Ilhan, Harun
          Knösel, Thomas
          Herrmann, Ken
          Issels, Rolf D
          Bartenstein, Peter
          Cyran, Clemens C
          Lindner, Lars H
          Hacker, Marcus
      sug:
      ab: 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 SUVmax, SUVpeak, SUVmax/SUVliver and SUVpeak/SUVliver showed good correlation with tumour grade. SUVpeak (area under the receiver-operating-characteristic, AUC-ROC: 0.82) and SUVpeak/SUVliver (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 SUVpeak/SUVliver 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 SUVpeak 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.
      pubtype: Academic Journal
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    language: English
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