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Oncology-Clinical Diagnosis: Solid TumorsSarcoma |
1 Saint Vincent's Hospital & Medical Center - Manhattan, New York, New York
595
Objectives: The objective of this retrospective study is to determine the accuracy and impact of FDG PET/CT vs. low dose CT and FDG PET alone in evaluating treatment response (ETR) in pts with BSTS.
Methods: FDG PET/CT was performed for ETR in 105 pts (58F/47M, mean age:48±16, range:17-86, underwent 278 studies) with biopsy proven BSTS. The studies were divided into 3 groups according to time after therapy as follows: Group1 (150 studies) TR (<2 month); Group2 (41 studies) short term follow-up (2-6 months); Group3 (87 studies) long term follow-up (>6 month). Final diagnoses were based on pathology, clinical and exam follow-up. Whole body PET/CT obtained with PET/CT scanner (GE Discovery) 60-90 minutes after administration of 10-15 mCi FDG.
Results: 702 lesions (310TP, 371TN, 15FP, 6FN) were identified on PET/CT. 534 lesions (76%) concordant between PET and CT vs. 168 lesions (24%) discordant. Based on lesion analysis, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for PET/CT is 98.1%, 96.1%, 97%, 95.4%, 98.4% vs. 84.7%, 82.5%, 83.5%, 79.6%, 86.9%, and 88.5%, 85.1%, 86.6%, 82.7%, 90.2% for PET and CT respectively. PET/CT accurately characterized TR in Group1 (97.4%), Group2 (95.1%) and Group3 (97.7%). CT showed correct TR in Group1 (83.3%), Group2 (80.5%) and Group3 (94.3%) vs. PET showed 90.7%, 82.9%, 85.1%, respectively. PET/CT incorrectly characterized TR in 8 pts (5 false progressions due to inflammation and/or post-surgical changes, 1 false complete response due to stunning, 1 false stable disease due to radiation therapy, 1 false partial response due to mass like infiltrate).
Conclusions: PET/CT is superior in ETR in patients with BSTS compared to PET or CT alone.
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