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[18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a diagnostic tool for neurofibromatosis 1 (NF1) associated malignant peripheral nerve sheath tumours (MPNSTs): a long-term clinical study.

AbstractBACKGROUND:
Malignant peripheral nerve sheath tumours (MPNSTs) are difficult to detect in neurofibromatosis 1 (NF1) individuals. The purpose was to evaluate [(18)F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) and PET computed tomography (CT) as a diagnostic tool for MPNST in NF1 patients with symptomatic plexiform neurofibromas and to verify the diagnosis by pathology and clinical follow-up.
PATIENTS AND METHODS:
NF1 individuals with symptomatic plexiform neurofibromas underwent clinical evaluation and magnetic resonance imaging. Qualitative FDG PET and PET CT associated with semi-quantitative maximum standard uptake value (SUVmax) assessed possible malignant change. Excision/biopsy verified the diagnosis when possible and clinical follow-up was undertaken in all patients.
RESULTS:
In all, 116 lesions were detected in 105 patients aged 5-71 years, including 80 plexiform neurofibromas, five atypical neurofibromas, 29 MPNST and two other cancers. Biopsy confirmed the findings in 59 tumours and no MPNST was diagnosed on clinical follow-up of 23 lesions diagnosed as benign on FDG PET and PET CT. FDG PET and PET CT diagnosed NF1-associated tumours with a sensitivity of 0.89 [95% confidence interval (CI) 0.76-0.96] and a specificity of 0.95 (CI 0.88-0.98), but the SUVmax level did not predict tumour grade.
CONCLUSION:
FDG PET and PET CT is a sensitive and specific diagnostic tool for NF1-associated MPNST. Other PET tracers will be required to solve the problem of predicting tumour grade.
AuthorsR E Ferner, J F Golding, M Smith, E Calonje, W Jan, V Sanjayanathan, M O'Doherty
JournalAnnals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 19 Issue 2 Pg. 390-4 (Feb 2008) ISSN: 1569-8041 [Electronic] England
PMID17932395 (Publication Type: Journal Article)
Chemical References
  • Fluorodeoxyglucose F18
Topics
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Biopsy, Needle
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Nerve Sheath Neoplasms (diagnostic imaging, pathology, physiopathology)
  • Neurofibroma, Plexiform (diagnostic imaging, pathology, physiopathology)
  • Neurofibromatosis 1 (diagnostic imaging, pathology, physiopathology)
  • Positron-Emission Tomography (methods)
  • Probability
  • Risk Assessment
  • Sensitivity and Specificity
  • Sex Factors
  • Tomography, X-Ray Computed

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