title: The Role of [18F]FDG-PET/CT in Predicting Malignant Transformation of Plexiform Neurofibromas in Neurofibromatosis-1.
abstract: Background. Malignant peripheral nerve sheath tumours (MPNSTs) are difficult to diagnose and treat and contribute to significant morbidity and mortality for patients with Neurofibromatosis-1 (NF-1). FDG-PET/CT is being increasingly used as an imaging modality to discriminate between benign and malignant plexiform neurofibromas.Objectives. To assess the value of FDG-PET/CT in differentiating between benign and malignant peripheral nerve lesions for patients with Neurofibromatosis-1.Methods. A systematic review of the literature was performed prior to application of stringent selection criteria. Ultimately 13 articles with 796 tumours were deemed eligible for inclusion into the review.Results. There was a significant difference between mean SUVmaxof benign and malignant lesions (1.93 versus 7.48, resp.). Sensitivity ranged from 89 to 100% and specificity from 72 to 94%. ROC analysis was performed to maximise sensitivity and specificity of SUVmaxcut-off; however no clear value was identified (range 3.1-6.1). Significant overlap was found between the SUVmaxof benign and malignant lesions making differentiation of lesions difficult. Many of the studies suffered from having a small cohort and from not providing histological data on all lesions which underwent FDG-PET/CT.Conclusion. This systematic review is able to demonstrate that FDG-PET/CT is a useful noninvasive test for discriminating between benign and malignant lesions but has limitations and requires further prospective trials.
authors.affiliation: Westmead Hospital, Cnr Hawkesbury and Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Camperdown, NSW, Australia.
authors.forename: David
authors.identifier: 0000-0002-3200-5725
authors.initials: D
authors.lastname: Tovmassian
authors.affiliation: Westmead Hospital, Cnr Hawkesbury and Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Camperdown, NSW, Australia.
authors.forename: Muzib
authors.initials: M
authors.lastname: Abdul Razak
authors.affiliation: Westmead Hospital, Cnr Hawkesbury and Darcy Rd, Westmead, NSW 2145, Australia; Nuclear Medicine, Westmead Children's Hospital, Westmead, NSW, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: London
mesh_terms: D002471:Cell Transformation, Neoplastic; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D018318:Neurofibroma, Plexiform / Q000000981:diagnostic imaging* / Q000473:pathology; D009456:Neurofibromatosis 1 / Q000150:complications / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18