The role of 18F-FDG PET/CT in soft tissue sarcoma

INTRODUCTION: Soft tissue sarcomas (STS) are highly fluorine-18-fluorodeoxyglucose (F-FDG)-avid tumours. PET seems to be effective for the assessment of the extent of disease. However, the use of PET to stratify STS into different risk histotypes still remains controversial. Our aim was to evaluate F-FDG uptake in different STS types and to assess the prognostic value of the maximum standardized uptake value (SUVmax).

PATIENTS AND METHODS: We reviewed 50 adult patients with primary high-grade STS of the extremities with a preoperative PET. Overall survival and local recurrence were analysed.

RESULTS: The mean SUVmax was 12.9 (range: 2.2-33.4). All cases of myxoid liposarcoma and all cases of synovial sarcoma had SUVmax of less than 10.3. A better overall survival and local recurrence were observed in patients with SUVmax of less than 10.3 (P=0.005 and 0.046, respectively).

CONCLUSION: SUVmax seems to be specific among different STS histotypes. PET does not seem to be useful in myxoid liposarcoma as well as synovial sarcoma as these tumours seem to have a low uptake of glucose. SUVmax might also be included as a prognostic factor.