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Abstract
Purpose
Recently, there have been many attempts to use PET-CT for the diagnosis of metastasis of soft tissue tumors and for differentiating benign tumors from malignant tumors. In this study, we wanted to evaluate the efficacy of 18-FDG PET CT in soft tissue tumors.
Materials and Methods
Patients (n=64) with suspected malignant soft tissue tumor had 18-FDG PET CT scans. This included 15 cases of benign soft tissue tumor, 34 cases of malignant soft tissue tumor and 15 cases of inflammatory lesions. All patients went through surgical treatment after PET-CT imaging was done, and all dissected tissues were biopsied. For semiquantitive analysis, SUVmax(Maximal standard uptake value) was measured, and SUVmax was determined using ROC analysis, the Kruskal-Wallis test and the Mann-Whitney test.
Results
Using 18-FDG PET CT it was possible to differentiate benign from malignant tumor using SUVmax values. But, discrimination between different grades of tumor was not possible. Also discrimination between malignant tumors and inflammatory lesions was not possible.
Conclusion
PET-CT can be considered as a useful nuclear imaging method that can detect local recurrence and distant metastasis of soft tissue sarcoma and can differentiate benign from malignant tumors. But PET-CT results must be interpreted carefully in diagnoses when there is inflammatory disease or a suspected lesion present.
Figures and Tables
Figure 1
Statistical data for patient subset based on tumor grade (Benign lesion, Grade I, Grade II, Grade III, Inflammatory lesion).
Figure 2
Comparison of ROC curves for differeniation with soft tissue sarcoma and benign soft tissue mass (AUC, 0.872; SE, 0.057; 95% CI, 0.760-0.983; p=0.000) (A), differentiation with liposarcoma and lipoma (AUC, 0977; SE, 0.031; 95% CI, 0.916-1.038; p=0.002) (B), and differentiation with low grade soft tissue sarcoma and benign soft tissue mass (AUC, 0858; SE, 0.079; 95% CI, 0.704-1.012; p=0.006) (C).
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