Heba Kamal Ali, Manar Hussein Abdel Sattar and Nehal Ali Abdel Mohsen
Cairo University, Egypt
Posters & Accepted Abstracts: J Nucl Med Radiat Ther
Objective: This study was done to review the clinical role of FDG-PET/CT in the initial staging, regional recurrence, distant metastasis and prognostication of bone and soft tissue sarcomas. Also to review the recent advances in the follow up, evaluation of the treatment response after systemic chemotherapy and/or radiotherapy, differentiation of recurrence versus fibrosis and post-treatment surveillance for recurrence in bone and soft tissue sarcomas by the use of FDG-PET/CT. Subjects & Methods: This study included 20 patients with sarcomas, 7 patients with biopsy proven osseous sarcoma and 13 patients with biopsy proven soft tissue sarcoma. Combined PET/CT scan was performed in one session. A whole body examination was performed starting from skull base to mid thighs; a whole body PET study was followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes. Analysis of PET images was done via visual and semi quantitative assessment (SUV max measurement). On interpreting fused PET/CT images, lesions were considered positive when areas of increased FDG uptake are localized to the lesion. Lesions were considered negative at areas lacking high FDG uptake. Results: There was no significant agreement in the detection of locoregional recurrence by PET/CT & CECT (P value=0.341), as they revealed similar results in 10 patients; 6 patients were positive and 4 patients were negative, while disagreed in 6 patients. Also, there was no significant agreement in the detection of distant metastasis by PET/CT & CECT (P value=0.394), as they yielded similar results in 10 patients while disagreed in 10. PET/CT was the best modality for detection of disease response, following treatment in follow up of patients with sarcomas as compared to CECT scan alone. Conclusion: PET/CT is a useful diagnostic tool for imaging and detection of soft tissue or osseous sarcomas. PET/CT seems to be superior compared with conventional imaging in determining the M stage of STS and BS. Both PET/CT and CECT are equal in determining the T stage. 18F-FDG PET/CT had greater diagnostic accuracy in the detection of recurrent bone or soft tissue sarcoma compared with CECT alone.
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