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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Functional imaging in soft tissue sarcomas: Update of the indications for 18F-FD...
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Vol. 39. Issue 4.
Pages 233-243 (July - August 2020)
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Vol. 39. Issue 4.
Pages 233-243 (July - August 2020)
Special collaboration
Functional imaging in soft tissue sarcomas: Update of the indications for 18F-FDG-PET/CT
Imagen funcional en sarcomas de partes blandas: actualización de las indicaciones de la 18F-FDG-PET/TC
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B. Rodríguez-Alfonsoa,
Corresponding author
brodrigueza@salud.madrid.org

Corresponding author.
, M. Simó-Perdigób, J. Orcajo Rincónc,d
a Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain
b Servicio de Medicina Nuclear, Hospital Universitari Vall d’Hebron, Barcelona, Spain
c Servicio de Medicina Nuclear, Hospital General Universitario Gregorio Marañón, Madrid, Spain
d Member of the del Grupo Español de Investigación en Sarcomas (GEIS)
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Tables (4)
Table 1. False positive and negative results of PET/CT in the differential diagnosis of benignity vs. malignancy of soft tissue lesions.
Table 2. AJCC Staging system for soft tissue sarcoma of the trunk or extremities.
Table 3. AJCC Staging system for retroperitoneal sarcomas.
Table 4. Sensitivity of PET for the detection of metastases.
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Abstract

Soft tissue sarcomas (STS) are a rare and heterogeneous group of tumors. They account for 1% of solid malignant tumors in adults and 7% in children and are responsible for 2% of cancer mortality. They require a multidisciplinary approach in centers with experience. This collaboration aims to update the scientific evidence to strengthen, together with clinical experience, the bases for the use and limitations of 18F-FDG-PET/CT in STSs. The general recommendations for the use of PET/CT in STS at present are summarized as the initial evaluation of soft tissue tumors when conventional image does not establish benignity with certainty and this determines the approach, in biopsy guiding in selected cases, in the initial staging, as additional tool, for rhabdomyosarcoma and STS of extremities or superficial trunk and head and neck tumors, in the suspicion of local recurrence when the CT or MRI are inconclusive and in the presence of osteosynthesis or prosthetic material and in assessment of therapy response to local/systemic therapy in stages ii/iii. In addition, PET/CT has the added value of being a surrogate marker of the histopathological response and it provides prognostic information, both in the baseline study and after treatment.

Keywords:
Soft tissue sarcomas
PET/CT
Functional imaging
18F-FDG
Resumen

Los sarcomas de partes blandas (SPB) son un grupo heterogéneo y poco frecuente de tumores. Suponen el 1% de los tumores malignos sólidos en adultos y el 7% en niños, y son responsables del 2% de la mortalidad por cáncer. Requieren un abordaje multidisciplinar en centros con experiencia. Esta colaboración pretende actualizar la evidencia científica para fortalecer, junto con la experiencia clínica, las bases del uso y las limitaciones de la 18F-FDG-PET/TC en los SPB. Las recomendaciones generales del uso de la PET/TC en SPB en la actualidad se resumen en la valoración inicial de lesiones de partes blandas cuando la imagen convencional no establece con certeza benignidad y ello condiciona el abordaje, en la guía de biopsia en casos seleccionados, en la estadificación inicial, como prueba adicional, del rabdomiosarcoma y SPB de extremidades o superficiales del tronco y cabeza y cuello, en la sospecha de recurrencia local cuando la TC o la RM no son concluyentes y ante la presencia de material de osteosíntesis o protésico, y en la valoración de respuesta a la terapia local/sistémica en SPB estadios ii/iii. Además, la PET/TC tiene el valor añadido de ser un marcador subrogado de la respuesta histopatológica en la pieza quirúrgica y de aportar información pronóstica tanto en el estudio basal como postratamiento.

Palabras clave:
Sarcomas de partes blandas
PET/TC
Imagen funcional
18F-FDG

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