Cardona S, Schwarzbach M, Hinz Ulf, Dimitrakopoulou-Strauss A, Attigah N, Mechtersheimer section sign G, Lehnert T
Section of Surgical Oncology, Department of Surgery, and Institute of Pathology, University of Heidelberg, Heidelberg, Germany.
Eur J Surg Oncol. 2003 Aug;29(6):536-41. doi: 10.1016/s0748-7983(03)00055-6.
Benign neurofibromas and malignant peripheral nerve sheath tumours (MPNST) commonly develop in patients with neurofibromatosis. Differentiation of benign from malignant tumours by conventional preoperative imaging is unreliable. FDG-PET is a non-invasive technique for biological tumour evaluation. The aim of this study was to assess the value of FDG-PET in patients with neurogenic tumours suspicious for MPNST.
Benign and malignant neurogenic soft tissue tumours were prospectively evaluated by computed tomography or magnetic resonance imaging. Three-dimensional qualitative and quantitative FDG-PET was performed. Standard uptake value (SUV) was analyzed with respect to histological diagnosis and follow-up data.
Twenty-five neurogenic soft tissue tumours were included. FDG-PET identified all primary (n=6) and recurrent MPNST (n=7). Benign lesions (n=12) did not demonstrate high FDG uptake. The SUV was significantly higher in MPNST (median 2.9; range 1.8-12.3), than in benign tumours (median 1.1; range 0.5-1.8) (p<0.001). At a cut-off value of 1.8 SUV measured 1 h post-injection FDG-PET distinguished between MPNST and benign neurogenic tumours with 100% sensitivity and 83% specificity.
FDG-PET allows discrimination of benign from malignant neurogenic tumours. This should be particularly useful in patients with neurofibromatosis as FDG-PET may help to avoid multiple surgical procedures for benign tumours.
良性神经纤维瘤和恶性外周神经鞘瘤（MPNST）常见于神经纤维瘤病患者。通过传统术前成像来区分良性与恶性肿瘤并不可靠。氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）是一种用于肿瘤生物学评估的非侵入性技术。本研究的目的是评估FDG-PET在疑似MPNST的神经源性肿瘤患者中的价值。
通过计算机断层扫描或磁共振成像对良性和恶性神经源性软组织肿瘤进行前瞻性评估。进行三维定性和定量FDG-PET检查。根据组织学诊断和随访数据分析标准摄取值（SUV）。
纳入了25例神经源性软组织肿瘤。FDG-PET识别出所有原发性（n = 6）和复发性MPNST（n = 7）。良性病变（n = 12）未显示出高FDG摄取。MPNST的SUV显著高于良性肿瘤（中位数2.9；范围1.8 - 12.3），而良性肿瘤的SUV中位数为1.1（范围0.5 - 1.8）（p<0.001）。在注射FDG后1小时测量，SUV的截断值为1.8时，FDG-PET区分MPNST和良性神经源性肿瘤的敏感性为100%，特异性为83%。
FDG-PET能够区分良性和恶性神经源性肿瘤。这对于神经纤维瘤病患者尤其有用，因为FDG-PET可能有助于避免对良性肿瘤进行多次手术。
