title: The Role of (18)F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma.
abstract: OBJECTIVE
  This research aims to investigate the potential of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET) to predict pathologic response after neoadjuvant chemotherapy (NAC) and overall survival (OS) of patients with synovial sarcoma in Korea.
  
  
  METHODS
  Twenty patients with synovial sarcoma from January 2001 to December 2011 were reviewed retrospectively. All patients underwent pre-treatment FDG PET and tumor removal. Patients were classified with the maximum SUV (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), age, sex, histologic subtype, tumor size, NAC, resection margin, and metastasis at diagnosis. Pathologic response was assessed using the French Federation of Cancer Centers system. Statistical analyses were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards regression model, and Mann-Whitney test.
  
  
  RESULTS
  Nine patients (45 %) showed pathologic response, and ten patients survived. Higher SUVmax, higher MTV, higher TLG, monophasic epithelial type, and metastasis at diagnosis were significantly related to poorer OS (p = 0.047, 0.016, 0.016, 0.045, and 0.018, respectively). By multivariate analysis, metastasis at diagnosis was significantly related to poorer OS (p = 0.012/HR = 5.9, 95 % CI 1.47 to 24.1). The SUVmax, MTV, and TLG of the non-responder group were significantly higher than those of the responder group (p = 0.020, 0.020, and 0.020, respectively). There was no significant difference in size between the two groups (p = 0.062).
  
  
  CONCLUSIONS
  A higher SUVmax on the pre-treatment scan, monophasic epithelial type, and metastasis at diagnosis were significantly associated with a poorer OS, and pathologic responders showed a higher SUVmax before NAC. The PET parameters can be used to predict OS and pathologic response in patients with synovial sarcomas before NAC.
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Kyoung Jin
authors.initials: KJ
authors.lastname: Chang
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Lim
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Joon Yeun
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: A Ra
authors.initials: AR
authors.lastname: Jo
authors.affiliation: Department of Orthopedics, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea.
authors.forename: Chang Bae
authors.initials: CB
authors.lastname: Kong
authors.affiliation: Department of Orthopedics, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea.
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Song
authors.affiliation: Department of Orthopedics, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea.
authors.forename: Wan Hyeong
authors.initials: WH
authors.lastname: Jo
authors.affiliation: Department of Orthopedics, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea.
authors.forename: Soo Yong
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea.
authors.forename: Jae Soo
authors.initials: JS
authors.lastname: Koh
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Byung Il
authors.initials: BI
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Chang Woon
authors.initials: CW
authors.lastname: Choi
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul 139-706 South Korea.
authors.forename: Sang Moo
authors.initials: SM
authors.lastname: Lim
keywords: 18F-FDG PET/CT; Prediction; Prognosis; Survival; Synovial sarcoma