(F-18) Fluorodeoxyglucose Positron Emission Tomography as a Predictor of Pathologic Grade and Other Prognostic Variables in Bone and Soft Tissue Sarcoma

• Published in: Clinical cancer research Vol. 6; no. 4; pp. 1279 - 1287
• Main Authors: FOLPE, A. L, LYLES, R. H, SPROUSE, J. T, CONRAD, E. U, EARY, J. F
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.04.2000
• Subjects: Adult; Aged; Biological and medical sciences; Bone Neoplasms - diagnosis; Bone Neoplasms - metabolism; Cyclin-Dependent Kinase Inhibitor p21; Cyclins - analysis; Data Interpretation, Statistical; Dermatology; Diseases of the osteoarticular system; Fluorodeoxyglucose F18; Humans; Immunohistochemistry; Ki-67 Antigen - analysis; Medical sciences; Middle Aged; Neoplasm Staging; Nuclear Proteins; Predictive Value of Tests; Prognosis; Proto-Oncogene Proteins - analysis; Proto-Oncogene Proteins c-mdm2; Sarcoma - diagnosis; Sarcoma - metabolism; Soft Tissue Neoplasms - diagnosis; Soft Tissue Neoplasms - metabolism; Tomography, Emission-Computed; Tumor Suppressor Protein p53 - analysis; Tumors of striated muscle and skeleton; Tumors of the skin and soft tissue. Premalignant lesions; Histological grading; Human; Cell proliferation; Fluorine Isotopes; Prognosis; Sarcoma; Mitosis; Diseases of the osteoarticular system; Malignant tumor; Gene expression; Carcinogenesis; Epidemiology; Investigation method; Osteosarcoma; Soft tissue; Bone; Predictive factor; Positron; Emission tomography
• ISSN: 1078-0432; 1557-3265

Positron emission tomography (PET) can be used to measure tumor metabolism in sarcomas by measuring the standard uptake value (SUV) of (F-18) fluorodeoxyglucose (FDG). FDG-PET SUV has been shown to correlate with histological grade. We compared FDG-PET SUV in 89 bone and soft tissue sarcomas with histopathological features, including tumor grade, as well as with markers of cell proliferation and cell cycle regulatory gene expression that may be prognostically or therapeutically important. All patients had undergone PET before biopsy. Features evaluated included grade (National Cancer Institute for soft tissue or Mayo Clinic for bone), cellularity, and the number of mitoses per 10 400× fields. Deparaffinized, formalin-fixed sections were immunostained with antibodies to Ki-67 (MIB-1), p53 (DO7), p21 WAF1 (EA10), and mdm-2 (1B10). For Ki-67, results were estimated as a percentage of positive cells. For p53 and mdm-2, only cases with >20% positive cells were considered to be overexpressing these proteins. For p21 WAF1 , only cases with <10% positive cells were considered to have lost normal p21 WAF1 expression. Tumor S-phase percentage and ploidy were determined by flow cytometry. FDG-PET SUV was associated with histopathological grade, cellularity, mitotic activity, MIB labeling index, and p53 overexpression. No association was seen with p21 WAF1 , mdm-2, S-phase fraction, or ploidy. Tumor metabolism data acquired by FDG-PET may help ensure accurate grading and prognostication in sarcoma by guiding biopsy toward the most biologically significant regions of large masses. Further follow-up will be necessary to determine whether FDG-PET provides independent prognostic information.