title: Semi-Quantitative Calculations of Primary Tumor Metabolic Activity Using F-18 FDG PET/CT as a Predictor of Survival in 92 Patients With High-Grade Bone or Soft Tissue Sarcoma.
abstract: To assess the prognostic value of primary tumor metabolic activity in patients with high-grade bone sarcomas (BS) or soft tissue sarcomas (STS) using F-18 FDG PET/CT. A single-site, retrospective study including 92 patients with high-grade BS or STS. Pretreatment F-18 FDG PET/CT scan was performed. Clinical data were registered. Accuracy of maximum standardized uptake value of primary tumor (SUVmax) and tumor-to-background (T/B) uptake ratio as prognostic variables and identification of cut-off values to group patients were determined. Kaplan-Meier survival estimates and log-rank test were used to compare survival distributions. Prognostic variables were assessed using Cox proportional hazards regression analysis. Forty-one of 92 patients died during follow-up (45%). Average survival was 6.5 years (95% CI 5.8-7.3 years) and probability of 5-year survival was 52%. Accuracy of SUVmax and T/B uptake ratio as prognostic variables in all patients and during subgroup analysis of patients with STS was significant. No significant results for AUCs were registered in patients with BS. Surgery was independently prognostic for survival throughout multivariate regression analysis of all patients (P = 0.001, HR 3.84) and subgroup analysis (BS: P = 0.02, HR 11.62; STS: P = 0.005, HR 4.13). SUVmax was significant as prognostic variable in all patients (P = 0.02, HR 3.66) and in patients with STS (P = 0.007, HR 3.75). No significant results were demonstrated for T/B uptake ratio. Estimation of primary tumor metabolic activity with pretherapeutic SUVmax using F-18 FDG PET/CT demonstrates independent properties beyond histologic grading for prediction of survival in patients with high-grade STS, but not with high-grade BS.
authors.affiliation: From the Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital (KFA, SHR, AL); and Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (HMF, MMP).
authors.forename: Kim Francis
authors.initials: KF
authors.lastname: Andersen
authors.forename: Hanna Maria
authors.initials: HM
authors.lastname: Fuglo
authors.forename: Sine Hvid
authors.initials: SH
authors.lastname: Rasmussen
authors.forename: Michael Mork
authors.initials: MM
authors.lastname: Petersen
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D002648:Child; D003718:Denmark / Q000453:epidemiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18