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Prognostic Value of Quantitative Parameters of 18 F-FDG PET/CT for Patients With Angiosarcoma.

PET/CT Updates, Research & Education
July 2020

Purpose

The purpose of this study was to evaluate quantitative parameters in 18F-FDG PET/CT in terms of correlation with histologic grade and overall survival in patients with angiosarcoma.

Methods

The cases of 16 patients with histologically confirmed angiosarcoma who had undergone pretreatment FDG PET/CT were retrospectively analyzed. Maximum standardized uptake value for the primary tumor (pSUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) for the whole body, tumor-to-blood ratio (TBR) for the primary tumor, and summed ratios of tumor-to-blood glycolytic activity for all lesions (whole-body TLG ratio) were calculated. Tumors were divided into high grade and low grade, according to the pathologic results. Correlations between these metabolic parameters and tumor grade were investigated. The prognostic value of these parameters and various clinicopathologic factors with respect to overall survival was assessed with the Cox proportional hazards regression model.

Results

Histopathologic examination revealed 10 high-grade and six low-grade tumors. Among the quantitative parameters, pSUVmax (p < 0.0001) and primary TBR (p = 0.0003) were significantly higher for high-grade tumors than for low-grade tumors. Ten patients died during follow-up (median survival time, 19.6 months). Higher pSUVmax (p = 0.040), MTV (p = 0.016), whole-body TLG (p = 0.010), primary TBR (p = 0.019), and whole-body TLG ratio (p = 0.007) correlated significantly with poorer overall survival. Single lesion at initial diagnosis (p = 0.0008) and performance of curative surgery (p = 0.0008) were strong favorable prognostic factors for overall survival, but histologic grade was not identified as a significant predictor.

Conclusion

In angiosarcoma, high-grade tumors had significantly higher pSUVmax and primary TBR at FDG PET/CT. All quantitative parameters evaluated in this study were found to be significant prognostic factors for overall survival.

Source: AJR Am J Roentgenol. 2020 Mar;214(3):649-657. doi: 10.2214/AJR.19.21635.
Epub 2020 Jan 15. < https://pubmed.ncbi.nlm.nih.gov/31939696 > Retrieved 25 June 2020.

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July Sarcoma Awareness Month

  • In adults sarcomas are estimated to be about 1% of all cancers. However, sarcomas make up about 15% of cancers in children under age 20.
  • Almost one half of bone sarcomas and about one fifth of soft tissue sarcomas are diagnosed in people under the age of 35.
  • 1 in approximately 350 people in the U.S. will be diagnosed with sarcoma at some point during their lifetime.

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