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- Title
Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence.
- 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
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.<bold>Key Points: </bold>• 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.
- Publication
European Radiology, 2015, Vol 25, Issue 8, p2214
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3654-y