Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

TY - JOUR

T1 - Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

AU - Andersen, Kim Francis

AU - Fuglo, Hanna Maria

AU - Rasmussen, Sine Hvid

AU - Petersen, Michael Mork

AU - Loft, Annika

PY - 2015/12

Y1 - 2015/12

N2 - The aim of the study is to assess the prognostic value of different volume-based calculations of tumor metabolic activity in the initial assessment of patients with high-grade bone sarcomas (BS) and soft tissue sarcomas (STS) using F-18 FDG PET/CT. A single-site, retrospective study from 2002 to 2012 including 92 patients with histologically verified high-grade BS (N=37) or STS (N=55). All patients underwent a pretreatment F-18 FDG PET/CT scan. Clinical data were registered. Measurements of the accuracy ofmetabolic tumor volume with a preset threshold of 40% of the maximum standardized uptake value of primary tumor (MTV40%) and total lesion glycolysis (TLG) as prognostic variables and identification of optimal discriminating cut-off valueswere performed through ROC curve analysis. Patientswere grouped according to the cut-off values. All deaths were considered an event in survival analysis. Kaplan-Meier survival estimates and log-rank test were used to compare the degree of equality of survival distributions. Prognostic variables with related hazard ratios (HR) were assessed using Cox proportional hazards regression analysis. Forty-one of 92 patients died during follow-up (45%; 12 BS and 29 STS). Average survival for included patients was 6.5 years (95% CI 5.8- 7.3 years) and probability of 5-year survival was 52%. There was a highsignificant accuracy of TLG and MTV40% as prognostic variables when looking on all patients and during subgroup analysis. AUCs were higher for TLGthan forMTV40%. TLGabove optimal cut-off value was the only variable which was independently prognostic for survival throughout multivariate regression analysis of all included patients (P=0.01, HR 4.78 [95% CI 1.45-15.87]) and subgroup analysis (BS: P=0.04, HR 11.11 [95% CI 1.09-111.11]; STS: P0.05, HR 3.37 [95% CI 1.02- 11.11]). No significant results were demonstrated for MTV40%. Volume-based F-18 FDG PET/CT imaging markers in terms of pretreatment estimation of TLG provide supplemental prognostic information to histologic grading, with significant independent properties for prediction of overall survival in patients with high-grade BS or STS. .

AB - The aim of the study is to assess the prognostic value of different volume-based calculations of tumor metabolic activity in the initial assessment of patients with high-grade bone sarcomas (BS) and soft tissue sarcomas (STS) using F-18 FDG PET/CT. A single-site, retrospective study from 2002 to 2012 including 92 patients with histologically verified high-grade BS (N=37) or STS (N=55). All patients underwent a pretreatment F-18 FDG PET/CT scan. Clinical data were registered. Measurements of the accuracy ofmetabolic tumor volume with a preset threshold of 40% of the maximum standardized uptake value of primary tumor (MTV40%) and total lesion glycolysis (TLG) as prognostic variables and identification of optimal discriminating cut-off valueswere performed through ROC curve analysis. Patientswere grouped according to the cut-off values. All deaths were considered an event in survival analysis. Kaplan-Meier survival estimates and log-rank test were used to compare the degree of equality of survival distributions. Prognostic variables with related hazard ratios (HR) were assessed using Cox proportional hazards regression analysis. Forty-one of 92 patients died during follow-up (45%; 12 BS and 29 STS). Average survival for included patients was 6.5 years (95% CI 5.8- 7.3 years) and probability of 5-year survival was 52%. There was a highsignificant accuracy of TLG and MTV40% as prognostic variables when looking on all patients and during subgroup analysis. AUCs were higher for TLGthan forMTV40%. TLGabove optimal cut-off value was the only variable which was independently prognostic for survival throughout multivariate regression analysis of all included patients (P=0.01, HR 4.78 [95% CI 1.45-15.87]) and subgroup analysis (BS: P=0.04, HR 11.11 [95% CI 1.09-111.11]; STS: P0.05, HR 3.37 [95% CI 1.02- 11.11]). No significant results were demonstrated for MTV40%. Volume-based F-18 FDG PET/CT imaging markers in terms of pretreatment estimation of TLG provide supplemental prognostic information to histologic grading, with significant independent properties for prediction of overall survival in patients with high-grade BS or STS. .

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bone Neoplasms

KW - Child

KW - Female

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Multimodal Imaging

KW - Positron-Emission Tomography

KW - Prognosis

KW - Proportional Hazards Models

KW - Radiopharmaceuticals

KW - Retrospective Studies

KW - Sarcoma

KW - Soft Tissue Neoplasms

KW - Tomography, X-Ray Computed

KW - Tumor Burden

KW - Young Adult

U2 - 10.1097/MD.0000000000002319

DO - 10.1097/MD.0000000000002319

M3 - Journal article

C2 - 26705220

SN - 0025-7974

VL - 94

SP - 1

EP - 7

JO - Medicine (Baltimore)

JF - Medicine (Baltimore)

IS - 51

M1 - e2319

ER -