The impact of 18F-FDG PET on initial staging and therapy planning of pediatric soft-tissue sarcoma patients

Elmanzalawy, Alaa; Vali, Reza; Chavhan, Govind; Gupta, Abha; Omarkhail, Yusuf; Amirabadi, Afsaneh; Shammas, Amer

doi:10.1007/s00247-019-04530-1

Cited by 25 publications

(4 citation statements)

References 39 publications

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“…For many malignant tumors, 18 F-fluorodeoxyglucose ( 18 F-FDG) is highly suitable as a PET tracer. Although sarcomas are uncommon, the use of 18 F-FDG-PET/CT for the detection, staging, and oncological management of sarcomas has increased considerably, leading to improved target volume delineation for radiooncological treatment approaches as well as evaluation of treatment response [1][2][3][4]. Moreover, 18 F-FDG-PET/CT provides a useful predictive tool for patients with soft tissue and bone sarcoma.…”

Section: Introductionmentioning

confidence: 99%

Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT

Koerber

Finck

Dendl

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose A high expression of fibroblast activation protein (FAP) was observed in multiple sarcomas, indicating an enormous potential for PET/CT using 68Ga-radiolabeled inhibitors of FAP (FAPI). Therefore, this retrospective study aimed to evaluate the role of the novel hybrid imaging probe for sarcomas as a first clinical evaluation. Methods A cohort of 15 patients underwent 68Ga-FAPI-PET/CT for staging or restaging. The acquisition of PET scans was performed 60 min after administration of 127 to 308 MBq of the tracer. The uptake of 68Ga-FAPI in malignant tissue as well as in healthy organs was quantified by standardized uptake values SUVmean and SUVmax. Results Excellent tumor-to-background ratios (> 7) could be achieved due to low background activity and high SUVmax in primary tumors (median 7.16), local relapses (median 11.47), and metastases (median 6.29). The highest uptake was found for liposarcomas and high-grade disease (range 18.86–33.61). A high SUVmax (> 10) was observed for clinically more aggressive disease. Conclusion These preliminary findings suggest a high potential for the clinical use of 68Ga-FAPI-PET/CT for patients diagnosed with sarcoma.

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Section: Introductionmentioning

confidence: 99%

Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT

Koerber

Finck

Dendl

et al. 2021

Eur J Nucl Med Mol Imaging

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“…In a study on 89 patients with osteosarcoma and STS Fuglo et al [22] reported that PET/CT at initial staging determined change in treatment in 18 out of 59 patients (30%), thus avoiding unnecessary surgery and switching to chemotherapy. Similarly, in a study by Elmanzalawy et al [25], 18 F-FDG PET/CT at staging demonstrated more lesions when compared to conventional imaging of 12 out of 26 pediatric patients with STS, but altered therapy planning only in five (19%). In a recent report in a wide, mixed population of bone and soft-tissue sarcomas, McPherson et al [16] demonstrated a potential "added value" of PET/CT over conventional imaging mainly for the detection of additional sites of metastatic disease, although the change in patient management was not addressed in this study.…”

Section: Discussionmentioning

confidence: 78%

Diagnostic and Clinical Impact of 18F-FDG PET/CT in Staging and Restaging Soft-Tissue Sarcomas of the Extremities and Trunk: Mono-Institutional Retrospective Study of a Sarcoma Referral Center

Annovazzi

Rea

Zoccali

et al. 2020

JCM

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Background: Soft-tissue sarcomas (STS) represent a wide heterogeneous class of rare tumors. The exact role 18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT) in the evaluation of STS is not well established. The aim of the present study was to evaluate how the use of 18F-FDG PET/CT in STS could influence patient therapy planning, looking for a possible added value over computed tomography and magnetic resonance imaging—the most used modalities in the study of STS. Differences in SUVmax according to histologic subtype and tumor grade were also considered. Methods: a total of 345 consecutive 18F-FDG PET/CT scans performed for initial staging (n = 171) or for suspected disease relapse (n = 174) in 282 patients with STS extracted from the local Information System database were retrospectively reviewed. Results: 18F-FDG PET/CT altered therapy planning in 80 cases (16.4% for staging and 29.9% in restaging), both for disease upstaging (58.8%) and downstaging (41.2%) Conclusions: 18F-FDG PET/CT could significantly influence management of patients with STS, particularly for restaging.

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“…In the second case (Figure 2), the 18 F-FDG PET-CT played a major role in giving both an accurate evaluation of the disease extent (staging and restaging) and a metabolic prognostic factor TLR that Baum et al [14] have correlated with the survival rate [19]. Our two cases are not a suggestion to use only serial 18 F-FDG PET-CT in the follow-up of these patients, but they represent an invitation to consider, as many works suggest [20][21][22][23][24], that the provided metabolic information could be extremely useful in the disease management, with an estimated 21% overall potential benefit of PET-CT over CT/MRI, in the "upstaging" of high-grade disease, as Macpherson et al demonstrated in a recent work [20].…”

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confidence: 73%

Usefulness of 18f-FDG PET-CT in Staging, Restaging, and Response Assessment in Pediatric Rhabdomyosarcoma

et al. 2020

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Rhabdomyosarcoma is the most common soft-tissue sarcoma of childhood. Despite clinical advances, subsets of these patients continue to suffer high morbidity and mortality rates associated with their disease. Following the European guidelines for 18F-FDG PET and PET-CT imaging in pediatric oncology, the routine use of 18F-FDG PET-CT may be useful for patients affected by rhabdomyosarcoma, in staging, in the evaluation of response to therapy, and for restaging/detection of relapse. The European Pediatric Protocols are very old, and for staging and restaging, they recommend only radionuclide bone scan. The 18F-FDG PET-CT exam is listed as an optional investigation prescribed according to local availability and local protocols in the investigations panel required at the end of the treatment. We present two cases highlighting the usefulness of 18F-FDG PET-CT in managing pediatric patients affected by rhabdomyosarcoma, providing some bibliographic references.

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The impact of 18F-FDG PET on initial staging and therapy planning of pediatric soft-tissue sarcoma patients

Cited by 25 publications

References 39 publications

Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT

Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT

Diagnostic and Clinical Impact of 18F-FDG PET/CT in Staging and Restaging Soft-Tissue Sarcomas of the Extremities and Trunk: Mono-Institutional Retrospective Study of a Sarcoma Referral Center

Usefulness of 18f-FDG PET-CT in Staging, Restaging, and Response Assessment in Pediatric Rhabdomyosarcoma

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