This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hawkins, D. S. Articles by Eary, J. F. Search for Related Content PubMed PubMed Citation Articles by Hawkins, D. S. Articles by Eary, J. F.

[¹⁸F]Fluorodeoxyglucose Positron Emission Tomography Predicts Outcome for Ewing Sarcoma Family of Tumors

From the Children’s Hospital and Regional Medical Center; and University of Washington Medical Center, Seattle, WA

Address reprint requests to Douglas Hawkins, MD, Children’s Hospital and Regional Medical Center, 4800 Sandpoint Way, Mailstop B-6553, Seattle, WA 98105-0371; e-mail: Doug.Hawkins{at}seattlechildrens.org

PURPOSE: Response to neoadjuvant chemotherapy is a significant prognostic factor for the Ewing sarcoma family of tumors (ESFTs). [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is a noninvasive imaging modality that accurately predicts histopathologic response in several malignancies. To determine the prognostic value of FDG PET response for progression-free survival (PFS) in ESFTs, we reviewed the University of Washington Medical Center experience.

PATIENTS AND METHODS: Thirty-six patients with ESFTs were evaluated by FDG PET. All patients received neoadjuvant and adjuvant chemotherapy. FDG PET standard uptake values before (SUV1) and after (SUV2) chemotherapy were analyzed and correlated with chemotherapy response, as assessed by histopathology in surgically excised tumors. Thirty-four patients had both SUV1 and SUV2.

RESULTS: The mean SUV1, SUV2, and ratio of SUV2 to SUV1 (SUV2:1) were 7.9 (range, 2.3 to 32.8), 2.1 (range, 0 to 4.3), and 0.36 (range, 0.00 to 1.00), respectively. Good FDG PET response was defined as SUV2 less than 2.5 or SUV2:1 0.5. FDG PET response by SUV2 or SUV2:1 was concordant with histologic response in 68% and 69% of patients, respectively. SUV2 was associated with outcome (4-year PFS 72% for SUV2 < 2.5 v 27% for SUV2 2.5, P = .01 for all patients; 80% for SUV2 < 2.5 v 33% for SUV2 2.5, P = .036 for localized at diagnosis patients). SUV2:1 0.5 was not predictive of PFS.

CONCLUSION: FDG PET imaging of ESFTs correlates with histologic response to neoadjuvant chemotherapy. SUV2 less than 2.5 is predictive of PFS independent of initial disease stage.

Supported by National Institutes of Health and National Cancer Institute Grants No. CA87721 and CA65537.

Presented in abstract form at the Connective Tissue Oncology Society Meeting, November 6-8, 2003, Barcelona, Spain.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

This article has been cited by other articles:

				A. K. Buck, K. Herrmann, C. M. z. Buschenfelde, M. E. Juweid, M. Bischoff, G. Glatting, G. Weirich, P. Moller, H.-J. Wester, K. Scheidhauer, et al. Imaging Bone and Soft Tissue Tumors with the Proliferation Marker [18F]Fluorodeoxythymidine Clin. Cancer Res., May 15, 2008; 14(10): 2970 - 2977. [Abstract] [Full Text] [PDF]

				S. M. Schuetze, L. H. Baker, R. S. Benjamin, and R. Canetta Selection of Response Criteria for Clinical Trials of Sarcoma Treatment Oncologist, April 1, 2008; 13(suppl_2): 32 - 40. [Abstract] [Full Text] [PDF]

				W. K. Hsu, M. S. Virk, B. T. Feeley, D. B. Stout, A. F. Chatziioannou, and J. R. Lieberman Characterization of Osteolytic, Osteoblastic, and Mixed Lesions in a Prostate Cancer Mouse Model Using 18F-FDG and 18F-Fluoride PET/CT J. Nucl. Med., March 1, 2008; 49(3): 414 - 421. [Abstract] [Full Text] [PDF]

				T. Volker, T. Denecke, I. Steffen, D. Misch, S. Schonberger, M. Plotkin, J. Ruf, C. Furth, B. Stover, H. Hautzel, et al. Positron Emission Tomography for Staging of Pediatric Sarcoma Patients: Results of a Prospective Multicenter Trial J. Clin. Oncol., December 1, 2007; 25(34): 5435 - 5441. [Abstract] [Full Text] [PDF]

				H. U. Gerth, K. U. Juergens, U. Dirksen, J. Gerss, O. Schober, and C. Franzius Significant Benefit of Multimodal Imaging: PET/CT Compared with PET Alone in Staging and Follow-up of Patients with Ewing Tumors J. Nucl. Med., December 1, 2007; 48(12): 1932 - 1939. [Abstract] [Full Text] [PDF]

				S. Biswal, D. L. Resnick, J. M. Hoffman, and S. S. Gambhir Molecular Imaging: Integration of Molecular Imaging into the Musculoskeletal Imaging Practice Radiology, September 1, 2007; 244(3): 651 - 671. [Abstract] [Full Text] [PDF]

				D. A. Mankoff, J. F. Eary, J. M. Link, M. Muzi, J. G. Rajendran, A. M. Spence, and K. A. Krohn Tumor-Specific Positron Emission Tomography Imaging in Patients: [18F] Fluorodeoxyglucose and Beyond Clin. Cancer Res., June 15, 2007; 13(12): 3460 - 3469. [Abstract] [Full Text] [PDF]

				T. I. Yock, M. Krailo, C. J. Fryer, S. S. Donaldson, J. S. Miser, Z. Chen, M. Bernstein, F. Laurie, Mark. C. Gebhardt, H. E. Grier, et al. Local Control in Pelvic Ewing Sarcoma: Analysis From INT-0091--A Report From the Children's Oncology Group J. Clin. Oncol., August 20, 2006; 24(24): 3838 - 3843. [Abstract] [Full Text] [PDF]

				M. Bernstein, H. Kovar, M. Paulussen, R. L. Randall, A. Schuck, L. A. Teot, and H. Juergensg Ewing's Sarcoma Family of Tumors: Current Management. Oncologist, May 1, 2006; 11(5): 503 - 519. [Abstract] [Full Text] [PDF]