Nerve Sheath Tumors in Neurofibromatosis Type 1: Assessment of Whole-Body Metabolic Tumor Burden Using F-18-FDG PET/CT

PLoS One. 2015 Dec 1;10(12):e0143305. doi: 10.1371/journal.pone.0143305. eCollection 2015.

Abstract

Purpose: To determine the metabolically active whole-body tumor volume (WB-MTV) on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in individuals with neurofibromatosis type 1 (NF1) using a three-dimensional (3D) segmentation and computerized volumetry technique, and to compare PET WB-MTV between patients with benign and malignant peripheral nerve sheath tumors (PNSTs).

Patients and methods: Thirty-six NF1 patients (18 patients with malignant PNSTs and 18 age- and sex-matched controls with benign PNSTs) were examined by F-18-FDG PET/CT. WB-MTV, whole-body total lesion glycolysis (WB-TLG) and a set of semi-quantitative imaging-based parameters were analyzed both on a per-patient and a per-lesion basis.

Results: On a per-lesion basis, malignant PNSTs demonstrated both a significantly higher MTV and TLG than benign PNSTs (p < 0.0001). On a per-patient basis, WB-MTV and WB-TLG were significantly higher in patients with malignant PNSTs compared to patients with benign PNSTs (p < 0.001). ROC analysis showed that MTV and TLG could be used to differentiate between benign and malignant tumors.

Conclusions: WB-MTV and WB-TLG may identify malignant change and may have the potential to provide a basis for investigating molecular biomarkers that correlate with metabolically active disease manifestations. Further evaluation will determine the potential clinical impact of these PET-based parameters in NF1.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18
  • Glycolysis
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Nerve Sheath Neoplasms / diagnosis*
  • Nerve Sheath Neoplasms / metabolism*
  • Nerve Sheath Neoplasms / pathology
  • Neurofibromatosis 1 / diagnosis*
  • Neurofibromatosis 1 / metabolism*
  • Neurofibromatosis 1 / pathology
  • Positron-Emission Tomography*
  • Tomography, X-Ray Computed*
  • Tumor Burden*
  • Young Adult

Substances

  • Fluorodeoxyglucose F18

Grants and funding

LP is employee of Mediso Medical Imaging Systems, Budapest, Hungary and ZT is employee of Scanomed Ltd, Budapest, Hungary. Mediso Medical Imaging Systems provided the software (InterViewTM FUSION) used to analyse the imaging data and both authors supported this work with repeated technical advice and support for optimized application of the semi-automatic volumetric software used in this work. There was no other funding of this work, especially no financial support to any of the other authors by Mediso Medical Imaging Systems or Scanomed Ltd.. The named commercial companies did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and did only provide financial support in the form of authors' salaries (LP and ZT). They provided support in the form of making available the software package used.