title: PET/CT allows stratification of responders to neoadjuvant chemotherapy for high-grade sarcoma: a prospective study.
abstract: OBJECTIVE
  The aim of the present study was to determine whether metabolic reduction is capable of reflecting the histopathologic response and outcome after neoadjuvant chemotherapy in patients with high-grade sarcoma.
  
  
  METHODS
  Forty-two patients with histologically proven high-grade sarcoma underwent neoadjuvant chemotherapy followed by surgical resection. Quantitative F-18 fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography scans were acquired before and after the first cycle and after completion of neoadjuvant chemotherapy. Standardized uptake values (SUVs) and metabolic reduction rates were compared with histopathologic response, progression-free survival, and overall survival.
  
  
  RESULTS
  Baseline SUVmax was 10.9 ± 3.6 (range, 3.8-19.6). Therapeutic effect resulted in 10 patients (24%) with a satisfactory response and in 32 patients (76%) with an unsatisfactory response after completion of neoadjuvant chemotherapy. The SUV decreased to 7.8 ± 3.4 after the first cycle (t1) of chemotherapy and to 5.2 ± 3.4 after completion (t2) of chemotherapy. Histopathologic response and percentage SUV (t2) reduction rate were independent predictors of progression-free survival and overall survival in the multivariate analyses.
  
  
  CONCLUSIONS
  Metabolic reduction after neoadjuvant chemotherapy evaluated by F-18 FDG PET or computed tomography can be used for stratification of the histopathologic response in patients with high-grade sarcoma.
authors.affiliation: Department of Radiology, Yokohama City University Graduate School of Medicine, Kanazawa-ku, Yokohama, Japan. utateish@yokohama-cu.ac.jp
authors.forename: Ukihide
authors.initials: U
authors.lastname: Tateishi
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chuman
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Nakatani
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Beppu
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Seki
authors.forename: Mototaka
authors.initials: M
authors.lastname: Miyake
authors.forename: Takashi
authors.initials: T
authors.lastname: Terauchi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Moriyama
authors.forename: E Edmund
authors.initials: EE
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed