Diagnostic Superiority of Dual-Time Point [<sup>18</sup>F]FDG PET/CT to Differentiate Malignant from Benign Soft Tissue Tumors

oleh: Philippe d’Abadie, Olivier Gheysens, Renaud Lhommel, François Jamar, Thomas Kirchgesner, Filomena Mazzeo, Laurent Coubeau, Halil Yildiz, An-Katrien De Roo, Thomas Schubert

Format: Article
Diterbitkan: MDPI AG 2023-10-01

Deskripsi

[<sup>18</sup>F]FDG PET/CT is used in the workup of indeterminate soft tissue tumors (STTs) but lacks accuracy in the detection of malignant STTs. The aim of this study is to evaluate whether dual-time point [<sup>18</sup>F]FDG PET/CT imaging (DTPI) can be useful in this indication. In this prospective study, [<sup>18</sup>F]FDG PET/CT imaging was performed 1 h (t1) and 3 h (t2) after injection. Tumor uptake (SUVmax) was calculated at each time point to define a retention index (RI) corresponding to the variation between t1 and t2 (%). Sixty-eight patients were included, representing 20 benign and 48 malignant tumors (including 40 sarcomas). The RI was significantly higher in malignant STTs than in benign STTs (median: +21.8% vs. −2%, <i>p</i> < 0.001). An RI of >14.3% predicted STT malignancy with a specificity (Sp) of 90% and a sensitivity (Se) of 69%. An SUVmax<sub>t1</sub> of >4.5 was less accurate with an Sp of 80% and an Se of 60%. In a subgroup of tumors with at least mild [<sup>18</sup>F]FDG uptake (SUVmax ≥ 3; <i>n</i> = 46), the RI significantly outperformed the diagnostic accuracy of SUVmax (AUC: 0.88 vs. 0.68, <i>p</i> = 0.01). DTPI identifies malignant STT tumors with high specificity and outperforms the diagnostic accuracy of standard PET/CT.