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J Nucl Med. 2008; 49 (Supplement 1):149P
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Oncology-Clinical Diagnosis: Solid Tumors

Sarcoma

Incremental value of FDG PET/CT in initial staging of patients (pts) with bone and soft tissue sarcoma (BSTS)

Henry Lin1, Elgin Ozkan1, Melih Erkan1, Fransico Viejo-Rullan1, Munir Mikhaeil1, Ali Mosavi1, Elena Piperkova1, Richard Libes1, Gerald Rosen1 and Hussein Abdel-Dayem1

1 Saint Vincent's Hospital & Medical Center - Manhattan, New York, New York

594

Objectives: To assess the accuracy and incremental value of PET/CT in initial staging of pts with BSTS. The impact of PET and CT alone was also assessed.

Methods: The FDG PET/CT images of 45 BSTS pts (22F/23M, mean age:51±17, range:24-86) with no chemo or radiotherapy were reviewed. 22 pts had surgery alone within 60 days before PET/CT. Histopathology includes: 2 angio, 1 chondro, 1 cysto, 1 desmoid, 3 Ewing, 2 fibro, 2 Kaposi, 10 leiomyo, 5 lipo, 11 osteo, 1 pleomorphic, 1 rhabdomyo, 1 spindle cell, 2 synovial sarcoma, 1 GIST and 1 hemangiopericytoma.

Results: PET/CT detected 101 lesions (55 TP, 43 TN, 2 FP, 1 FN). There were 77 concordant (C) (50 TP, 25 TN, 1 FP, 1 FN) and 24 discordant (DC) lesions between the PET and CT images. 1 C-FP on PET/CT was due to adrenal hyperplasia and 1 DC-FP due to FDG avid normal size reactive lymph node. 1 C-FN result in the right axillary lymph node concordant in all imaging modality and histopathological examination showed viable tumor. Overall the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT is 98.2%, 95.6%, 97%, 96.5% and 97.7% versus 96.4%, 88.9%, 93.1%, 91.5% and 95.2% for CT. PET alone demonstrates 91.1% sensitivity, 64.4% specificity, 79.2% accuracy, 76.2% PPV, and 85.3% NPV. PET/CT altered patient management in 27% (12/45) of pts due to detection of unexpected metastases (lung, bone, liver, adrenal, soft tissue, thyroid) in 11 pts and identified a secondary primary (thyroid carcinoma) in 1 patient.

Conclusions: PET/CT demonstrates higher sensitivity, specificity, accuracy, PPV and NPV than PET or CT alone and alters patient management in 27% of patients with bone and soft tissue sarcoma.





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Right arrow Articles by Lin, H.
Right arrow Articles by Abdel-Dayem, H.
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Right arrow Articles by Lin, H.
Right arrow Articles by Abdel-Dayem, H.