Risk assessment based on FDG-PET imaging in patients with synovial sarcoma.
Synovial sarcoma generally is associated with poor prognosis. With recent advances in molecular biology, it has become apparent not all synovial sarcomas share the same tumor biology. (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is useful for risk assessment in several types of sarcomas. We therefore assessed the clinical value of (18)F-FDG-PET-derived maximum standard uptake value (SUV(max)) for predicting survival in patients with synovial sarcoma. (18)F-FDG-PET was performed in 44 patients with synovial sarcoma before therapy and resection. SUV(max) was calculated for each tumor and then evaluated for prognostic usefulness along with metastasis at presentation, tumor grade, histopathologic subtype, age, gender, postsurgical margins, anatomic location, and tumor size for overall survival and progression-free survival. SUV(max) ranged from 1.2 to 13.0 (median, 4.35). Pretherapy tumor SUV(max) predicted overall survival and progression-free survival. Patients presenting with a SUV(max) greater than 4.35 had a decreased disease-free survival and were therefore at high risk for having local recurrences and metastatic disease.


METHODS
Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Lisle
Jennifer W
JW
Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA. jennifer.lisle@gmail.com
Eary
Janet F
JF
O'Sullivan
Janet
J
Conrad
Ernest U
EU
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013584:Sarcoma, Synovial / Q000000981:diagnostic imaging* / Q000473:pathology; D016019:Survival Analysis
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18