Functional image in soft tissue sarcomas: An update of the indications of 18F-FDG-PET/CT

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Jul-Aug;39(4):233-243. doi: 10.1016/j.remn.2020.06.001. Epub 2020 Jun 29.
[Article in English, Spanish]

Abstract

Soft tissue sarcomas (STS) are a rare and heterogeneous group of tumors. They account for 1% of solid malignant tumors in adults and 7% in children and are responsible for 2% of cancer mortality. They require a multidisciplinary approach in centers with experience. This collaboration aims to update the scientific evidence to strengthen, together with clinical experience, the bases for the use and limitations of 18F-FDG-PET/CT in STSs. The general recommendations for the use of PET/CT in STS at present are summarized as the initial evaluation of soft tissue tumours when conventional image does not establish benignity with certainty and this determines the approach; in biopsy guiding in selected cases; in the initial staging, as additional tool, for rhabdomyosarcoma and STS of extremities or superficial trunk and head and neck tumours; in the suspicion of local recurrence when the CT or MRI are inconclusive and in the presence of osteosynthesis or prosthetic material and in assessment of therapy response to local/systemic therapy in stages ii/iii. In addition, PET/CT has the added value of being a surrogate marker of the histopathological response and it provides prognostic information, both in the baseline study and after treatment.

Keywords: (18)F-FDG; Functional imaging; Imagen funcional; PET/CT; PET/TC; Sarcomas de partes blandas; Soft tissue sarcomas.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Diagnosis, Differential
  • False Negative Reactions
  • False Positive Reactions
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18*
  • Humans
  • Image-Guided Biopsy / methods
  • Neoadjuvant Therapy
  • Neoplasm Metastasis / diagnostic imaging*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Staging / methods
  • Positron Emission Tomography Computed Tomography / methods*
  • Practice Guidelines as Topic
  • Prognosis
  • Radiopharmaceuticals*
  • Sarcoma / diagnostic imaging*
  • Sarcoma / pathology
  • Sarcoma / secondary
  • Sarcoma / therapy
  • Sensitivity and Specificity
  • Soft Tissue Neoplasms / diagnostic imaging*
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / therapy
  • Treatment Outcome

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Fluorine-18