Abstract | BACKGROUND: 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.
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Authors | R E Ferner, J F Golding, M Smith, E Calonje, W Jan, V Sanjayanathan, M O'Doherty |
Journal | Annals 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 |
PMID | 17932395
(Publication Type: Journal Article)
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Chemical References |
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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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