Imaging Characteristics and Prognostic Value of18F-FDG PET/CT in Primary Osteosarcoma
10.3969/j.issn.1005-5185.2015.05.014
- VernacularTitle:原发性骨肉瘤18F-FDG PET/CT影像特征及预后评价
- Author:
Jin FENG
;
Zhengming WANG
;
Lianna ZHANG
;
Fang YANG
- Publication Type:Journal Article
- Keywords:
Osteosarcoma;
Positron-emission tomography;
Tomography,X-ray computed;
Fluorodeoxyglucose F18;
Prognosis
- From:
Chinese Journal of Medical Imaging
2015;(5):377-382,387
- CountryChina
- Language:Chinese
-
Abstract:
PurposeTo discuss the imaging characteristics and prognostic value of 18F-FDG PET/CT in primary osteosarcoma.Materials and MethodsThirty patients with osteosarcoma confirmed by pathology were enrolled in the study. The imaging characteristics of preoperative whole body18F-FDG PET/CT were analyzed retrospectively. The max standard uptake values (SUVmax) and CT values of lesions were obtained, and tumor volume was calculated; disease-free survival duration was calculated according to the reoccurrence and metastasis of tumor and death; the SUVmax of different components was compared, and the SUVmax in each position was analyzed in terms of the correlation with the corresponding CT value and factors influencing the prognosis.ResultsCT images showed that 28 patients with primary osteosarcoma had bone destruction, 20 had ground-glass or cotton-like neoplastic bone, 24 with soft tissue mass and 16 with periosteal reaction had increased18F-FDG uptake, and 17 with high-density neopalstic bone had low 18F-FDG uptake. The SUVmax of high-density neoplastic bone was significantly lower than that of bone destruction, low-density neoplastic bone and soft tissue mass (F=5.196, P<0.01). There was a weak negative correlation between the SUVmax of various parts such as bone destruction, low-density neoplastic bone, high-density neoplastic bone and soft tissue mass and the corresponding CT value (r=-0.315,P<0.01). The disease free survival time was (36.9±14.9) months. The Kaplan-Meier curve analysis showed that the disease free survival time was longer in patients with SUVmax≥9 than in those with SUVmax<9 (χ2=0.696,P<0.05). The Cox regression analysis presented that SUVmax had independent prognostic value (Wald=4.213,P<0.05).Conclusion18F-FDG PET/CT has advantages in presenting the anatomical structure changes and metabolic changes in primary osteosarcoma. Combined with semi-quantitative analysis of SUVmax, PET/CT can be helpful in finding out the highest biological activity part from the complex tumor structures. Neoplastic bone with low density/high metabolism suggests high malignancy. The higher the SUVmax, the worse the prognosis is in patients with primary osteosarcoma.
