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KMID : 0613320050110010032
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Journal of the Korean Bone and Joint Tumor Soceity
2005 Volume.11 No. 1 p.32 ~ p.39
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Diagnostic Efficacy of PET in Soft Tissue Tumors: Comparative Study with Conventional Methods
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Seo Seong-Wook
Park Sang-Min
Cho Hwan-Seong
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Abstract
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Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor.
Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated.
The incremental cost accuracy ratio was determined in each diagnostic method.
Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000 ￦/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors.
Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.
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KEYWORD
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fluorodeoxyglucose positron emission tomography scans (PET), Soft tissue sarcoma, Cost-effectiveness analysis
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