Abstract | BACKGROUND: METHODS: It is a multicenter retrospective study conducted between 2000 to 2012. All patients with NF1 referred for suspected MPNST underwent PET. Since SUVmax was not available until 2004 in our centers, we had to settle for the semi-quantitative method used at that time, the uptake ratio between the tumor and the normal liver (T/L ratio) with 1.5 as the cut-off for malignancy. When dedicated PET with SUVmax became available, the semi-quantitative analysis of PET images remained, along with SUVmax. RESULTS: 113 patients with 145 tumors were included. PET assessment revealed 65 suspected lesions with T/L >1.5 and among these, 40 were MPNSTs. 80 tumors were classified as non-suspicious, and 79 were benign. The 1.5 T/L cut-off had a negative predictive value (NPV) of 98,8% and a positive predictive value of 61,5%. The positive likelihood ratio (LR) was 4,059, the negative LR was 0,032 with 97% sensitivity and 76% specificity. CONCLUSIONS: This study, which is among the largest published, confirms the utility of PET for detecting NF1-associated MPNSTs. A semi-quantitative index, the T/L ratio with a cut-off of 1.5, allowed sensitive and specific differentiation of malignant from benign tumors better than SUVmax. When T/L was <1.5, MPNSTs were ruled out with 98,8% NPV. When T/L was >1.5, there was a strong suspicion of malignancy. This semi-quantitative analytical method is as simple as SUVmax, but is more sensitive, more reproducible and non-user-dependent.
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Authors | Patrick Combemale, Laurence Valeyrie-Allanore, Francesco Giammarile, Stephane Pinson, Bernard Guillot, Denis Mariano Goulart, Pierre Wolkenstein, Jean Yves Blay, Thomas Mognetti |
Journal | PloS one
(PLoS One)
Vol. 9
Issue 2
Pg. e85954
( 2014)
ISSN: 1932-6203 [Electronic] United States |
PMID | 24516522
(Publication Type: Journal Article, Multicenter Study)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Cell Transformation, Neoplastic
(pathology)
- Child
- Child, Preschool
- Demography
- Female
- Fluorodeoxyglucose F18
- Humans
- Liver
(diagnostic imaging, pathology)
- Liver Neoplasms
(diagnostic imaging, pathology)
- Male
- Middle Aged
- Neurofibromatosis 1
(complications, diagnostic imaging)
- Positron-Emission Tomography
- Sarcoma
(complications, diagnostic imaging, pathology)
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