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Initial McGill Experience with Fluorodeoxyglucose pet/ct Staging of Soft-Tissue Sarcoma

Department of Radiation Oncology, McGill University Health Centre, Montreal, QC 3G 1A4, Canada
Department of Nuclear Medicine, McGill University Health Centre, Montreal, QC, Canada
Department of Nuclear Medicine, Lakeshore General Hospital, Pointe-Claire, QC, Canada
Department of Orthopedics, McGill University Health Centre, Montreal, QC, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2010, 17(6), 18-22;
Submission received: 3 August 2010 / Revised: 3 September 2010 / Accepted: 4 October 2010 / Published: 1 November 2010


Background: Soft-tissue sarcoma spreads predominantly to the lung. The frequency with which positron-emission tomography (PET) detects metastases not already obvious by chest computed tomography (CT) or clinical examination is currently unclear. Methods: We retrospectively identified cases of soft-tissue sarcoma. Ewing sarcoma, rhabdomyosarcoma, and gastrointestinal stromal tumour were excluded, as were cases in which patients underwent imaging for follow-up, response assessment, or recurrence. Patients all had undergone diagnostic chest CT as part of their staging. Directed studies were requested to follow up on abnormal findings in the clinical history or physical examination. All charts and pre-treatment imaging were reviewed retrospectively. Results: From 2004 to 2008, 75 patients met the criteria for the present review. Their median age was 51 years. In 21% of cases, the primary tumour had been removed (by excisional biopsy or unplanned excision) before staging. Of the previously unresected primary tumours, 97% were avid for fluorodeoxyglucose. Of all tumours, 81% were intermediate or high grade (Fédération Nationale des Centres de Lutte Contre le Cancer grades 2–3). The primary tumour was stage T2b in 69% of cases. The most common primary site was a lower extremity (55%). The most common pathologic diagnoses were leiomyosarcoma (21%), liposarcoma (19%), and synovial sarcoma (17%). At the end of staging, 17% of patients were considered to have metastatic disease. Imaging by PET was negative for distant disease in 64 of the 75 cases. In 7 of the 64 cases, metastatic disease was evident on chest CT (negative predictive value: 88%). Imaging by PET was positive in 8 cases, with 5 of those already known to have metastases, 2 having pathologically proven false positives, and 1 being a new finding of a pulmonary metastasis (positive predictive value: 75%). The PET imaging was indeterminate in 3 patients (none of whom subsequently developed metastatic disease). Two incidental benign parotid tumours were found. Overall, only 1 patient was upstaged as a result of PET imaging (1.3%). In addition, PET did not alter the management of patients already know to have M1 disease (no new organ sites identified). Conclusions: Although PET may be helpful in specific circumstances, routine use of fluorodeoxyglucose PET imaging for detection of metastatic disease as part of the initial staging of soft-tissue sarcoma added little to imaging by chest CT and was unlikely to alter management in our series.
Keywords: soft-tissue sarcoma; positron-emission tomography; staging soft-tissue sarcoma; positron-emission tomography; staging

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MDPI and ACS Style

Roberge, D.; Hickeson, M.; Charest, M.; Turcotte, R.E. Initial McGill Experience with Fluorodeoxyglucose pet/ct Staging of Soft-Tissue Sarcoma. Curr. Oncol. 2010, 17, 18-22.

AMA Style

Roberge D, Hickeson M, Charest M, Turcotte RE. Initial McGill Experience with Fluorodeoxyglucose pet/ct Staging of Soft-Tissue Sarcoma. Current Oncology. 2010; 17(6):18-22.

Chicago/Turabian Style

Roberge, D., M. Hickeson, M. Charest, and R. E. Turcotte. 2010. "Initial McGill Experience with Fluorodeoxyglucose pet/ct Staging of Soft-Tissue Sarcoma" Current Oncology 17, no. 6: 18-22.

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