Title : The role of the FDG PET-CT in patients with Ewing sarcoma
The purpose of our retrospective study was to evaluate the potential role of [18F]fluorodeoxyglucose positron emission tomography/computed tomography ( FDG PET-CT) in the staging and assessment of chemotherapy response in patients with Ewing sarcoma.
Materials and methods. Thirteen patients with Ewing sarcoma during a 4-year period were included. Nine patients presented metastatic disease, mainly in the lungs. The images of the whole-body FDG PET investigations were visually analysed and compared to bone scintigraphy regarding bone lesions and to CT and/or MRI for the primary tumor and for visceral metastasis.
Results. FDG PET-CT and conventional imaging (CT or MRI) were equally effective in the detection of primary tumor. All metastatic lung lesions were detected by spiral CT, but some of the lung lesions failed to be detected using PET-CT.
About bone lesions, both FDG PET-CT and bone scans were able to identify bone metastasis but FDG PET-CT identified more lesions than bone scans as it can detect metastatic bone lesions before reactive-osteoblastic activity becomes visible in the bone scan.
Conclusion. The use of PET-TC in Ewing sarcoma can improve sensitivity and diagnostic accuracy. FDG PET-CT scans appear to be superior to bone scans in the detection of bone metastases in all districts except skull bones. For the depiction of small lesions of less than 7 mm, mainly represented by pulmonary metastases, PET-TC is less sensitive than computed tomography. In addition, PET-TC, by providing functional data, can evaluate tumor response to therapy earlier than other imaging procedures.
Audience Take Away:
- The advantages and limits of PET-CT in patients with Ewing sarcoma
- The potential use of PET-CT for a personalized approach