PURPOSE: The aim of this study was to compare the diagnostic performance of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT and whole-body MRI for the detection of malignant peripheral nerve sheath tumors (MPNSTs) in patients with neurofibromatosis type 1, and to evaluate a panel of imaging-based criteria serving that purpose. PATIENTS AND METHODS: Thirty-one patients were examined by whole-body MRI and ¹⁸F-FDG PET/CT. A panel of imaging-based criteria including tumor region, size, shape, margin definition, contrast enhancement, heterogeneity before and after contrast, intratumoral lobulation, target sign, and mean and maximum standardized uptake values (SUVs) were evaluated. A SUVmax cut-off value of 3.5 was used for lesion analysis. Histopathologic evaluation and/or clinical follow-up served as the reference standard. RESULTS: ¹⁸F-FDG PET/CT had a sensitivity of 100%, whereas MRI had a sensitivity of 66.7%. On PET/CT, tumor size (P<0.005), SUVmax (P<0.0001), SUVmean (P<0.0001), and tracer uptake heterogeneity (P=0.002) were significantly associated with MPNSTs. On MRI, intratumoral lobulation (P<0.02), ill-defined margins (P=0.007), and irregular enhancement on T1-weighted imaging (P<0.001) were significantly associated with MPNSTs. CONCLUSIONS: Both PET/CT and whole-body MRI may distinguish benign and malignant PNSTs, but PET/CT has higher sensitivity for that purpose. Imaging-based criteria for identification of MPNSTs on both modalities were identified. False-positive results, requiring biopsy or clinical follow-up, may be reduced by using a combination of MRI and PET derived markers, but only at the price of reduced sensitivity.
PURPOSE: The aim of this study was to compare the diagnostic performance of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT and whole-body MRI for the detection of malignant peripheral nerve sheath tumors (MPNSTs) in patients with neurofibromatosis type 1, and to evaluate a panel of imaging-based criteria serving that purpose. PATIENTS AND METHODS: Thirty-one patients were examined by whole-body MRI and ¹⁸F-FDG PET/CT. A panel of imaging-based criteria including tumor region, size, shape, margin definition, contrast enhancement, heterogeneity before and after contrast, intratumoral lobulation, target sign, and mean and maximum standardized uptake values (SUVs) were evaluated. A SUVmax cut-off value of 3.5 was used for lesion analysis. Histopathologic evaluation and/or clinical follow-up served as the reference standard. RESULTS: ¹⁸F-FDG PET/CT had a sensitivity of 100%, whereas MRI had a sensitivity of 66.7%. On PET/CT, tumor size (P<0.005), SUVmax (P<0.0001), SUVmean (P<0.0001), and tracer uptake heterogeneity (P=0.002) were significantly associated with MPNSTs. On MRI, intratumoral lobulation (P<0.02), ill-defined margins (P=0.007), and irregular enhancement on T1-weighted imaging (P<0.001) were significantly associated with MPNSTs. CONCLUSIONS: Both PET/CT and whole-body MRI may distinguish benign and malignant PNSTs, but PET/CT has higher sensitivity for that purpose. Imaging-based criteria for identification of MPNSTs on both modalities were identified. False-positive results, requiring biopsy or clinical follow-up, may be reduced by using a combination of MRI and PET derived markers, but only at the price of reduced sensitivity.
Authors: J Uthoff; F A De Stefano; K Panzer; B W Darbro; T S Sato; R Khanna; D E Quelle; D K Meyerholz; J Weimer; J C Sieren Journal: J Neuroradiol Date: 2018-06-27 Impact factor: 3.447
Authors: Christian Philipp Reinert; Martin Ulrich Schuhmann; Benjamin Bender; Isabel Gugel; Christian la Fougère; Jürgen Schäfer; Sergios Gatidis Journal: Eur J Nucl Med Mol Imaging Date: 2018-12-08 Impact factor: 9.236
Authors: Lennart Well; Johannes Salamon; Michael G Kaul; Said Farschtschi; Jochen Herrmann; Karin I Geier; Christian Hagel; Maximilian Bockhorn; Peter Bannas; Gerhard Adam; Victor F Mautner; Thorsten Derlin Journal: Neuro Oncol Date: 2019-03-18 Impact factor: 12.300
Authors: Johannes Salamon; Simon Veldhoen; Ivayla Apostolova; Peter Bannas; Jin Yamamura; Jochen Herrmann; Reinhard E Friedrich; Gerhard Adam; Victor F Mautner; Thorsten Derlin Journal: Eur Radiol Date: 2013-10-05 Impact factor: 5.315
Authors: Stephen M Broski; Geoffrey B Johnson; Benjamin M Howe; Mark A Nathan; Doris E Wenger; Robert J Spinner; Kimberly K Amrami Journal: Skeletal Radiol Date: 2016-04-26 Impact factor: 2.199