Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi 110029, India.
Eur J Nucl Med Mol Imaging. 2013 Jul;40(7):1036-43. doi: 10.1007/s00259-013-2388-9. Epub 2013 Apr 5.
To evaluate the diagnostic accuracy of (18)F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma.
We retrospectively analysed data from 53 patients (age 20.1 ± 10.5 years, 39 male) who had undergone 71 (18)F-FDG PET/CT studies for suspected recurrence (52 studies) or for routine follow-up (19 studies) after primary therapy of skeletal Ewing sarcoma. (18)F-FDG PET/CT studies were evaluated qualitatively and quantitatively (maximum standardized uptake value, SUVmax) by two nuclear medicine physicians in consensus. Sensitivity, specificity, predictive values and accuracy were calculated on per study basis. Clinical/imaging follow-up (minimum 6 months) and/or histopathology (when available) were taken as the reference standard.
Of the total of 71 (18)F-FDG PET/CT studies, 42 (59.1%) were positive for recurrence and 29 (40.9%) were negative for recurrence. Local recurrence was most common (38 studies) followed by bone metastasis (9 studies), and node and lung metastasis (2 studies each). Of the 71 studies, 38 were true-positive, 27 were true-negative, 4 were false-positive and 2 were false-negative. Overall per study based sensitivity was 95%, specificity was 87%, PPV was 90%, NPV was 93% and accuracy was 91.5%. No significant difference was found in the accuracy of PET/CT between the suspected recurrence group and the routine follow-up group (94% vs. 84%; P = 0.390). Overall mean lesion SUVmax was 7.8 ± 4.1 (range 1.9-17.2). No site-based difference was found in SUVmax.
(18)F-FDG PET/CT demonstrates high diagnostic accuracy for detecting recurrence in patients with primary skeletal Ewing sarcoma, when it is suspected (clinically or on imaging) or during routine follow-up.
评估（18）F-FDG PET/CT 检测原发性骨尤文肉瘤患者复发的诊断准确性。
我们回顾性分析了 53 例患者（年龄 20.1±10.5 岁，39 例男性）的资料，这些患者在接受原发性骨尤文肉瘤治疗后，因疑似复发（52 次）或常规随访（19 次）而进行了 71 次（18）F-FDG PET/CT 检查。两名核医学医师通过共识对（18）F-FDG PET/CT 研究进行定性和定量评估（最大标准化摄取值，SUVmax）。根据每项研究计算敏感性、特异性、预测值和准确性。以临床/影像学随访（至少 6 个月）和/或组织病理学（如有）作为参考标准。
71 次（18）F-FDG PET/CT 研究中，42 次（59.1%）为复发阳性，29 次（40.9%）为复发阴性。局部复发最常见（38 次），其次是骨转移（9 次），淋巴结和肺转移各 2 次。在 71 项研究中，38 项为真阳性，27 项为真阴性，4 项为假阳性，2 项为假阴性。基于每项研究的总体敏感性为 95%，特异性为 87%，PPV 为 90%，NPV 为 93%，准确性为 91.5%。在疑似复发组和常规随访组之间，PET/CT 的准确性无显著差异（94%比 84%；P=0.390）。总体平均病灶 SUVmax 为 7.8±4.1（范围 1.9-17.2）。在 SUVmax 方面，没有发现与部位相关的差异。
（18）F-FDG PET/CT 对检测原发性骨尤文肉瘤患者的复发具有较高的诊断准确性，无论是在可疑（临床或影像学）还是常规随访时。
