Zhu Yan-Lin, Sun Yi-Wen, Ge Yu-Chen, He Jian, Li Ru-Tian
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, Jiangsu Province, China.
The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China.
World J Radiol. 2025 Jul 28;17(7):106427. doi: 10.4329/wjr.v17.i7.106427.
Soft tissue sarcomas (STS) are rare malignant tumors originating from mesodermal tissues with a poor prognosis, accounting for approximately 1% of all malignancies and comprising around 50 distinct subtypes. Conventional imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), primarily provide anatomical information, whereas F-fluorodeoxyglucose positron emission tomography/CT (F-FDG PET/CT) integrates functional metabolic and anatomical imaging, serving as a critical complementary tool in the diagnosis and management of STS. This article reviews recent advances in the application of F-FDG PET/CT for STS. The advantages of F-FDG PET/CT in STS include: (1) Early detection of metabolic activity changes in tumors, particularly when morphological alterations are insignificant; (2) Effective differentiation between benign and malignant soft tissue tumors, as well as aiding in distinguishing high-grade from low-grade sarcomas; (3) Identification of occult metastatic lesions, improving staging accuracy, and facilitating restaging in cases of recurrence or metastasis; (4) Utilization of parameters such as maximum standardized uptake value and metabolic tumor volume to assist in tumor grading and prognostic evaluation; and (5) Monitoring treatment response to guide adjustments in personalized therapeutic strategies. However, F-FDG PET/CT has limitations in diagnosis of certain STS subtypes (, myxoid liposarcoma), detection and biopsy of metastatic lymph nodes, necessitating integration with clinical evaluation and other imaging techniques. F-FDG PET/CT is poised to play an increasingly vital role in the precision diagnosis and treatment of STS.
软组织肉瘤（STS）是起源于中胚层组织的罕见恶性肿瘤，预后较差，约占所有恶性肿瘤的1%，包含约50种不同亚型。传统成像方式，如计算机断层扫描（CT）和磁共振成像（MRI），主要提供解剖学信息，而氟代脱氧葡萄糖正电子发射断层扫描/CT（F-FDG PET/CT）整合了功能代谢和解剖成像，是STS诊断和管理中的关键补充工具。本文综述了F-FDG PET/CT在STS应用中的最新进展。F-FDG PET/CT在STS中的优势包括：（1）早期检测肿瘤代谢活性变化，尤其是形态学改变不明显时；（2）有效区分良性和恶性软组织肿瘤，并有助于区分高级别与低级别肉瘤；（3）识别隐匿性转移灶，提高分期准确性，并便于在复发或转移情况下进行再分期；（4）利用最大标准化摄取值和代谢肿瘤体积等参数辅助肿瘤分级和预后评估；以及（5）监测治疗反应以指导个性化治疗策略的调整。然而，F-FDG PET/CT在某些STS亚型（如黏液样脂肪肉瘤）的诊断、转移淋巴结的检测和活检方面存在局限性，需要与临床评估和其他成像技术相结合。F-FDG PET/CT在STS的精准诊断和治疗中有望发挥越来越重要的作用。
