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Published in: Skeletal Radiology 10/2016

01-10-2016 | Scientific Article

Comparison of MRI and PET-CT in detecting the loco-regional recurrence of soft tissue sarcomas during surveillance

Authors: Sun-Young Park, Hye Won Chung, Sun Young Chae, Jong-Seok Lee

Published in: Skeletal Radiology | Issue 10/2016

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Abstract

Objective

To investigate the diagnostic performance of MRI and PET-CT for the detection of loco-regional recurrences after soft tissue sarcoma (STS) excision.

Materials and Methods

From Dec 2003 to Aug 2014, 394 patients with STSs, who were included in the electronic patient registry for initial or repeated surgery at our hospital, were retrospectively reviewed. We identified 152 patients who underwent regular postoperative follow-ups with both MRI and PET-CT, obtained within a 3 month period of each other. We analyzed differences in the performance of MRI and PET-CT for the diagnosis of loco-regional recurrences using McNemar’s test. The receiver-operating characteristic curves and calculations of the area under the curve were used.

Results

Twenty patients were found to have a loco-regional recurrence after tumor excision. For MRI and PET-CT, the sensitivities were 90.0 and 95.0 %, and the specificities 97.7 and 95.5 %, respectively, with positive predictive values of 85.7 and 76.0 % and negative predictive values of 98.5 and 99.2 %, respectively. No significant difference was detected between the sensitivities of MRI and PET-CT (p = 0.125). The area under the receiver-operating characteristic curve for PET-CT (0.952) was not significantly greater than that for MRI (0.939; p = 0.6).

Conclusion

MRI of the area of interest is recommended for evaluation of tumor recurrence after surgical excision of STS. PET-CT was shown to be effective for detection of STS recurrence, and comparable to MRI. However, if PET-CT or MRI findings are inconclusive, the other modality may be helpful in differentiating tumor recurrence from post-therapeutic tissue change.
Literature
1.
go back to reference Clark MA, Fisher C, Judson I, Thomas JM. Soft-tissue sarcomas in adults. N Engl J Med. 2005;353:701–11.CrossRefPubMed Clark MA, Fisher C, Judson I, Thomas JM. Soft-tissue sarcomas in adults. N Engl J Med. 2005;353:701–11.CrossRefPubMed
2.
go back to reference Fletcher CDM, Unni KK, Mertens F. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC; 2002. Fletcher CDM, Unni KK, Mertens F. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC; 2002.
4.
go back to reference Potter DA, Glenn J, Kinsella T, et al. Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985;3:353–66.PubMed Potter DA, Glenn J, Kinsella T, et al. Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985;3:353–66.PubMed
5.
go back to reference Moureau-Zabotto L, Thomas L, Bui BN, et al. Management of soft tissue sarcomas (STS) in first isolated local recurrence: a retrospective study of 83 cases. Radiother Oncol. 2004;73:313–9.CrossRefPubMed Moureau-Zabotto L, Thomas L, Bui BN, et al. Management of soft tissue sarcomas (STS) in first isolated local recurrence: a retrospective study of 83 cases. Radiother Oncol. 2004;73:313–9.CrossRefPubMed
6.
go back to reference Tinkle CL, Weinberg V, Braunstein SE, et al. Intraoperative radiotherapy in the management of locally recurrent extremity soft tissue sarcoma. Sarcoma. 2015;2015:913565.CrossRefPubMedPubMedCentral Tinkle CL, Weinberg V, Braunstein SE, et al. Intraoperative radiotherapy in the management of locally recurrent extremity soft tissue sarcoma. Sarcoma. 2015;2015:913565.CrossRefPubMedPubMedCentral
7.
go back to reference Fontanesi J, Mott MP, Lucas DR, Miller PR, Kraut MJ. The role of irradiation in the management of locally recurrent non-metastatic soft tissue sarcoma of extremity/trunkal locations. Sarcoma. 2004;8:57–61.CrossRefPubMedPubMedCentral Fontanesi J, Mott MP, Lucas DR, Miller PR, Kraut MJ. The role of irradiation in the management of locally recurrent non-metastatic soft tissue sarcoma of extremity/trunkal locations. Sarcoma. 2004;8:57–61.CrossRefPubMedPubMedCentral
8.
go back to reference Kransdorf MJ, Murphey MD. Soft tissue tumors: post-treatment imaging. Radiol Clin North Am. 2006;44:463–72.CrossRefPubMed Kransdorf MJ, Murphey MD. Soft tissue tumors: post-treatment imaging. Radiol Clin North Am. 2006;44:463–72.CrossRefPubMed
10.
go back to reference Tagliafico A, Truini M, Spina B, et al. Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound. Eur Radiol. 2015:1–7. Tagliafico A, Truini M, Spina B, et al. Follow-up of recurrences of limb soft tissue sarcomas in patients with localized disease: performance of ultrasound. Eur Radiol. 2015:1–7.
12.
go back to reference Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25:iii102–12. Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25:iii102–12.
13.
go back to reference Garner HW, Kransdorf MJ, Bancroft LW, et al. Benign and malignant soft-tissue tumors: posttreatment MR imaging 1. Radiographics. 2009;29:119–34.CrossRefPubMed Garner HW, Kransdorf MJ, Bancroft LW, et al. Benign and malignant soft-tissue tumors: posttreatment MR imaging 1. Radiographics. 2009;29:119–34.CrossRefPubMed
14.
go back to reference Vanel D, Shapeero LG, De Baere T, et al. MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations. Radiology. 1994;190:263–8.CrossRefPubMed Vanel D, Shapeero LG, De Baere T, et al. MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations. Radiology. 1994;190:263–8.CrossRefPubMed
15.
go back to reference Reuther G, Mutschler W. Detection of local recurrent disease in musculoskeletal tumors: magnetic resonance imaging versus computed tomography. Skeletal Radiol. 1990;19:85–90.CrossRefPubMed Reuther G, Mutschler W. Detection of local recurrent disease in musculoskeletal tumors: magnetic resonance imaging versus computed tomography. Skeletal Radiol. 1990;19:85–90.CrossRefPubMed
16.
go back to reference Diana Afonso P, Kosinski AS, Spritzer CE. Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis? Eur J Radiol. 2013;82:806–13.CrossRefPubMed Diana Afonso P, Kosinski AS, Spritzer CE. Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis? Eur J Radiol. 2013;82:806–13.CrossRefPubMed
17.
go back to reference Johnson GR, Zhuang H, Khan J, Chiang SB, Alavi A. Roles of positron emission tomography with fluorine-18-deoxyglucose in the detection of local recurrent and distant metastatic sarcoma. Clin Nucl Med. 2003;28:815–20.CrossRefPubMed Johnson GR, Zhuang H, Khan J, Chiang SB, Alavi A. Roles of positron emission tomography with fluorine-18-deoxyglucose in the detection of local recurrent and distant metastatic sarcoma. Clin Nucl Med. 2003;28:815–20.CrossRefPubMed
18.
go back to reference Kole AC, Nieweg OE, van Ginkel RJ, et al. Detection of local recurrence of soft-tissue sarcoma with positron emission tomography using [18F]fluorodeoxyglucose. Ann Surg Oncol. 1997;4:57–63.CrossRefPubMed Kole AC, Nieweg OE, van Ginkel RJ, et al. Detection of local recurrence of soft-tissue sarcoma with positron emission tomography using [18F]fluorodeoxyglucose. Ann Surg Oncol. 1997;4:57–63.CrossRefPubMed
19.
go back to reference Lucas J, O’Doherty M, Wong J, et al. Evaluation of fluorodeoxyglucose positron emission tomography in the management of soft-tissue sarcomas. J Bone Joint Surg (Br). 1998;80:441–7.CrossRef Lucas J, O’Doherty M, Wong J, et al. Evaluation of fluorodeoxyglucose positron emission tomography in the management of soft-tissue sarcomas. J Bone Joint Surg (Br). 1998;80:441–7.CrossRef
20.
go back to reference Vanel D, Lacombe M, Couanet D, Kalifa C, Spielmann M, Genin J. Musculoskeletal tumors: follow-up with MR imaging after treatment with surgery and radiation therapy. Radiology. 1987;164:243–5.CrossRefPubMed Vanel D, Lacombe M, Couanet D, Kalifa C, Spielmann M, Genin J. Musculoskeletal tumors: follow-up with MR imaging after treatment with surgery and radiation therapy. Radiology. 1987;164:243–5.CrossRefPubMed
21.
go back to reference Mulcahy H, Chew FS. MRI of nontumorous skeletal muscle disease: case-based review. AJR Am J Roentgenol. 2011;196:S77–85.CrossRefPubMed Mulcahy H, Chew FS. MRI of nontumorous skeletal muscle disease: case-based review. AJR Am J Roentgenol. 2011;196:S77–85.CrossRefPubMed
22.
go back to reference Schwarzbach MH, Dimitrakopoulou-Strauss A, Willeke F, et al. Clinical value of [18-F] fluorodeoxyglucose positron emission tomography imaging in soft tissue sarcomas. Ann Surg. 2000;231:380–6.CrossRefPubMedPubMedCentral Schwarzbach MH, Dimitrakopoulou-Strauss A, Willeke F, et al. Clinical value of [18-F] fluorodeoxyglucose positron emission tomography imaging in soft tissue sarcomas. Ann Surg. 2000;231:380–6.CrossRefPubMedPubMedCentral
23.
go back to reference Chang KJ, Kong CB, Cho WH, et al. Usefulness of increased 18F-FDG uptake for detecting local recurrence in patients with extremity osteosarcoma treated with surgical resection and endoprosthetic replacement. Skeletal Radiol. 2015;44:529–37.CrossRefPubMed Chang KJ, Kong CB, Cho WH, et al. Usefulness of increased 18F-FDG uptake for detecting local recurrence in patients with extremity osteosarcoma treated with surgical resection and endoprosthetic replacement. Skeletal Radiol. 2015;44:529–37.CrossRefPubMed
24.
go back to reference Jones DN, McCowage GB, Sostman HD, et al. Monitoring of neoadjuvant therapy response of soft-tissue and musculoskeletal sarcoma using fluorine-18-FDG PET. J Nucl Med. 1996;37:1438–44.PubMed Jones DN, McCowage GB, Sostman HD, et al. Monitoring of neoadjuvant therapy response of soft-tissue and musculoskeletal sarcoma using fluorine-18-FDG PET. J Nucl Med. 1996;37:1438–44.PubMed
25.
go back to reference Iagaru A, Masamed R, Chawla SP, Menendez LR, Fedenko A, Conti PS. F-18 FDG PET and PET/CT evaluation of response to chemotherapy in bone and soft tissue sarcomas. Clin Nucl Med. 2008;33:8–13.CrossRefPubMed Iagaru A, Masamed R, Chawla SP, Menendez LR, Fedenko A, Conti PS. F-18 FDG PET and PET/CT evaluation of response to chemotherapy in bone and soft tissue sarcomas. Clin Nucl Med. 2008;33:8–13.CrossRefPubMed
26.
go back to reference Rothermundt C, Whelan J, Dileo P, et al. What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients. Br J Cancer. 2014;110:2420–6.CrossRefPubMedPubMedCentral Rothermundt C, Whelan J, Dileo P, et al. What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients. Br J Cancer. 2014;110:2420–6.CrossRefPubMedPubMedCentral
27.
go back to reference Watts AC, Teoh K, Evans T, Beggs I, Robb J, Porter D. MRI surveillance after resection for primary musculoskeletal sarcoma. J Bone Joint Surg (Br). 2008;90:484–7.CrossRef Watts AC, Teoh K, Evans T, Beggs I, Robb J, Porter D. MRI surveillance after resection for primary musculoskeletal sarcoma. J Bone Joint Surg (Br). 2008;90:484–7.CrossRef
28.
go back to reference Cheney MD, Giraud C, Goldberg SI, et al. MRI surveillance following treatment of extremity soft tissue sarcoma. J Surg Oncol. 2014;109:593–6.CrossRefPubMed Cheney MD, Giraud C, Goldberg SI, et al. MRI surveillance following treatment of extremity soft tissue sarcoma. J Surg Oncol. 2014;109:593–6.CrossRefPubMed
29.
go back to reference Labarre D, Aziza R, Filleron T, et al. Detection of local recurrences of limb soft tissue sarcomas: is magnetic resonance imaging (MRI) relevant? Eur J Radiol. 2009;72:50–3.CrossRefPubMed Labarre D, Aziza R, Filleron T, et al. Detection of local recurrences of limb soft tissue sarcomas: is magnetic resonance imaging (MRI) relevant? Eur J Radiol. 2009;72:50–3.CrossRefPubMed
30.
go back to reference Strander H, Turesson I, Cavallin-Stahl E. A systematic overview of radiation therapy effects in soft tissue sarcomas. Acta Oncol. 2003;42:516–31.CrossRefPubMed Strander H, Turesson I, Cavallin-Stahl E. A systematic overview of radiation therapy effects in soft tissue sarcomas. Acta Oncol. 2003;42:516–31.CrossRefPubMed
Metadata
Title
Comparison of MRI and PET-CT in detecting the loco-regional recurrence of soft tissue sarcomas during surveillance
Authors
Sun-Young Park
Hye Won Chung
Sun Young Chae
Jong-Seok Lee
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 10/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-016-2440-5

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