Ruggiero Antonio, Lanni Valerio, Librizzi Alberto, Maurizi Palma, Attinà Giorgio, Mastrangelo Stefano, Giordano Alessandro, Riccardi Riccardo
Division of Paediatric Oncology.
Institute of Nuclear Medicine, Catholic University of Rome, Rome, Italy.
J Pediatr Hematol Oncol. 2018 May;40(4):277-284. doi: 10.1097/MPH.0000000000001135.
The purpose of this study was to evaluate the potential role of fluorine-18 fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET-CT) in the staging and assessment of chemotherapy response in Ewing sarcoma.
For 13 patients with Ewing sarcoma, whole-body FDG PET-CT was assessed for site of primary disease, disease extent, and response to therapy. Chest CT, localized magnetic resonance imaging or CT of primary site, and bone scintigrams were evaluated for imaging features of the primary lesion and presence or absence of metastatic disease. Response to therapy was also assessed. Descriptive statistics are reported.
Nine patients (69%) presented metastatic disease. All metastatic lung lesions were detected by spiral CT, but some failed to be detected using FDG PET-CT. As regards bone lesions, both FDG PET-CT and bone scans were able to identify bone metastasis, but FDG PET-CT identified more lesions than bone scans. All PET-CT scans at the end of the neoadjuvant chemotherapy showed a decreased FDG uptake.
FDG PET-CT seems to be superior to bone scan in the detection of bone metastasis in all districts except skull bones. For pulmonary metastasis smaller than 7 mm, FDG PET-CT is less sensitive than CT. FDG PET-CT may have an important role in initial staging of Ewing sarcoma and subsequent evaluation of response to therapy.
本研究的目的是评估氟-18氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET-CT）在尤因肉瘤分期及化疗反应评估中的潜在作用。
对13例尤因肉瘤患者进行全身FDG PET-CT检查，以评估原发疾病部位、疾病范围及治疗反应。对胸部CT、原发部位的局部磁共振成像或CT以及骨闪烁扫描进行评估，以确定原发病变的影像学特征及是否存在转移性疾病。同时评估治疗反应。报告描述性统计结果。
9例（69%）患者出现转移性疾病。所有肺转移瘤均通过螺旋CT检测到，但部分转移瘤FDG PET-CT未能检测到。对于骨病变，FDG PET-CT和骨扫描均能识别骨转移，但FDG PET-CT识别出的病变比骨扫描更多。新辅助化疗结束时所有PET-CT扫描均显示FDG摄取减少。
除颅骨外，FDG PET-CT在各部位骨转移的检测方面似乎优于骨扫描。对于小于7毫米的肺转移瘤，FDG PET-CT的敏感性低于CT。FDG PET-CT在尤因肉瘤的初始分期及后续治疗反应评估中可能具有重要作用。
