Purandare Nilendu C, Shah Sneha, Agrawal Archi, Puranik Ameya, Rangarajan Venkatesh
Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National University (HBNI), Mumbai, Maharashtra, India.
Indian J Nucl Med. 2021 Jul-Sep;36(3):327-339. doi: 10.4103/ijnm.ijnm_242_20. Epub 2021 Sep 23.
Bone and soft-tissue tumors display a wide range of metabolic activity on flurodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT) imaging due to their varying histopathological features. Several benign tumors show high FDG uptake similar to that seen in malignant lesions and their metabolic characteristics can overlap. Certain benign tumors can potentially undergo malignant transformation and FDG PET/CT can play an important role in detecting malignant change. The intensity of metabolic activity on FDG PET/CT correlates with histological grade of malignant tumors and also acts as a valuable prognostic factor. FDG PET/CT plays an important role in the staging work up of bone and soft-tissue malignancies. It has been found to be superior to conventional imaging techniques primarily for detecting distant metastatic disease. Because of its ability to detect metabolic changes, FDG PET/CT is a very useful in assessing response to treatment. Metabolic response seen on FDG PET is a powerful surrogate marker of histopathological response to chemotherapy. The purpose of this article is to study the variable patterns of FDG uptake in tumors of the musculoskeletal system, describe the clinical utility of FDG PET/CT in predicting malignant change in benign tumors and discuss its role in staging, response assessment, and prognostication of malignant lesions.
由于骨和软组织肿瘤具有不同的组织病理学特征,在氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG PET/CT)成像上显示出广泛的代谢活性。一些良性肿瘤表现出与恶性病变相似的高FDG摄取,它们的代谢特征可能重叠。某些良性肿瘤可能会发生恶性转化,FDG PET/CT在检测恶性变化方面可发挥重要作用。FDG PET/CT上的代谢活性强度与恶性肿瘤的组织学分级相关,也是一个有价值的预后因素。FDG PET/CT在骨和软组织恶性肿瘤的分期检查中发挥着重要作用。已发现它主要在检测远处转移疾病方面优于传统成像技术。由于其能够检测代谢变化,FDG PET/CT在评估治疗反应方面非常有用。FDG PET上看到的代谢反应是对化疗的组织病理学反应的有力替代标志物。本文的目的是研究肌肉骨骼系统肿瘤中FDG摄取的可变模式,描述FDG PET/CT在预测良性肿瘤恶性变化方面的临床应用,并讨论其在恶性病变分期、反应评估和预后中的作用。