Value of FDG Positron Emission Tomography in Conjunction with MR Imaging for Evaluating Therapy Response in Patients with Musculoskeletal Sarcomas
- 1 November 2002
- journal article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 179 (5), 1145-1150
- https://doi.org/10.2214/ajr.179.5.1791145
Abstract
OBJECTIVE. The purpose of our study was to investigate the potential of FDG positron emission tomography (PET) to distinguish viable tumor from changes caused by therapy in areas with equivocal MR imaging findings in patients with musculoskeletal sarcomas. MATERIALS AND METHODS. We evaluated 12 patients (nine males, three females; age range, 9-56 years; mean age, 25 years) with a history of bone or soft-tissue sarcoma who had undergone various treatments (surgery, chemotherapy, radiation therapy, or a combination of treatments) and who presented with clinically suspected recurrent or residual tumor. All patients underwent gadopentetate dimeglumine—enhanced MR imaging and whole-body FDG PET. Imaging results were correlated with histologic findings or with clinical findings from long-term follow-up. RESULTS. In nine patients, MR imaging findings were equivocal in differentiating between posttherapeutic changes and tumor recurrence. FDG PET images showed increased uptake, suggestive of recurrent tumor, in five patients. These findings were confirmed by biopsy. Four patients showed no increased uptake on FDG PET and were closely monitored clinically. No tumor recurrence was found in these patients. One patient showed MR imaging findings suggestive of recurrent tumor that was confirmed on FDG PET and at histology. Two patients underwent a limb salvage procedure before MR imaging, but MR images were deemed inadequate for interpretation because of extensive metallic artifacts. FDG PET was helpful in evaluating these patients for tumor recurrence. CONCLUSION. FDG PET is a useful adjunct to MR imaging in distinguishing viable tumor from posttherapeutic changes in patients with bone and soft-tissue sarcomas.Keywords
This publication has 13 references indexed in Scilit:
- Post-therapeutic Magnetic Resonance Imaging of Bone TumorsTopics in Magnetic Resonance Imaging, 1999
- Limb Salvage and Outcome of OsteosarcomaClinical Orthopaedics and Related Research, 1999
- Dynamic contrast-enhanced MRI with subtraction of aggressive soft tissue tumors after resectionSkeletal Radiology, 1998
- Preoperative evaluation and monitoring chemotherapy in patients with high-grade osteogenic and Ewing's sarcoma: review of current imaging modalitiesSkeletal Radiology, 1998
- Effects of pediatric cancer therapy on the musculoskeletal systemPediatric Radiology, 1997
- Benign versus malignant intraosseous lesions: discrimination by means of PET with 2-[F-18]fluoro-2-deoxy-D-glucose.Radiology, 1996
- Local control of soft tissue sarcoma of the extremity: The experience of a multidisciplinary sarcoma group with definitive surgery and radiotherapyEuropean Journal Of Cancer, 1994
- Prognostic factors in osteosarcoma: a critical review.Journal of Clinical Oncology, 1994
- Survival, prognosis, and therapeutic response in osteogenic sarcoma. The memorial hospital experienceCancer, 1992
- Neoadjuvant chemotherapy of osteosarcoma: results of a randomized cooperative trial (COSS-82) with salvage chemotherapy based on histological tumor response.Journal of Clinical Oncology, 1988