Study On The Application Of Pet/CT For The Diagnosis Of Bone And Soft Tissue Sarcomas

The diagnosis and treatment of bone soft tissue sarcomas have always been a challenge for surgeons.PET/CT can not only precis ely show the anatomi cal struc ture of the organs in the body,but also can demonstrate the rate of met abolism of the cells and tissues in thes e organs.It has al ready become an important imaging modality for tumor di agnos is and treatment guidance.Howe ver,thanks to the low incidence of bone and soft tissue sa r comas,the value of PET/CT in the diagnosis of bone and soft tiss ue sarcomas i s st ill deba tabl e.If there is a s tudy i ncludi ng a large quantity of patients who wer e c onfirmed with the diagnosis of primary bone and soft tissue sa rcoma and PET/CT t ests of those lesions,it could be hel pful t o explore the potential value of thi s c utti ng edge technique a nd provide guidance for its fur ther application in the orthopedic clinic al prac tic e.To find out the val ue of PET/CT study in t he diagnosis of bone and soft tissue sarcomas and provide guidance for the future application of PET/CT in the clinical practice of orthopedic oncology,t he current r esearc h c arried out s tatistical analysis on t he he radiological materials of patients pr esente d to t he orthopedic oncology surgery department of Beijing Ji Shui Tan Hospital for t he treatme nt of primary bone and soft t issue sarcomas.Data regurding the PET/CT test and histopa thologic diagnosis of tumor s were collected.SPSS statistics 17.0 statist ical soft war e was used for the calc ulations of SUVmax of difference t ypes of sarcomas.As a result,a total of 426 bone and soft tiss ue s arcomas found in 314 PET/ CT tests of 264 patients(including 115 patients with primary bone sa rcomas and 149 pat ient s with soft tissue sarcomas)were included in the current study.The aver age SUVma x of ost eosarcoma was 8.0 ± 6.0(range: 1.5-30.2),chondrosarcoma: 7.0± 4.8(range:0-26.5),Ewing’s sarcoma :6.1±2.9(range:2-15),chordoma: 3.9±1.9(r ange :1.5-8.6),synovial sarcoma 5.7±3.3(r ange:1.2-15.0),spindle cell sa rcoma:5.8±4.1(range :1.5-23.4),pleomorphic undifferentiated sarcoma:9.5±5.6(range:2.5-23.4),l iposarcoma: 3.6±1.8(ra nge:1.3-7.8),small cell sarcoma:8.1±5.5(range:2.8-20.0),alveolar soft part s arcoma: 4.1±1.4(range:1.6-10.4),leiomyosarcoma 为 6.9±3.8(ra nge:3.5-17.6),rhabdomyosarcoma 4.3±1.8(r ange:1.5-6).PET/CT ha ve accurately diagnosed 96.6% of all primary oss eous sarcomas and 91.2% of all soft tissue sarcomas,and sensitivity of PET/ CT for oss eous and soft tiss ue sarcomas that di d not undergo a ny chemo or surgic al trea tment was 98.8% and94.9%.The a verage SUVmax of high grade osse ous sarcoma s(10.6 ± 6.0)was significantly(P<0.01)higher tha n that of low grade oss eous s arcomas(3.6 ± 1.4).With SUVmax=5.2 as threshold,PET/CT was able to discriminate high and l ow grade osseous sarcoma s with the s ensitivity of 92.6% and spec ificity of 86.7%.No significant di fference was found between the SUVma x of high and low grade soft tiss ue sarcomas(P>0.05).Resul ts of the current study indicate that PET/CT can acc urate ly diagnose most os seous and soft tissue sarcomas.Specifi cally,PET/CT has near 100% sensitivity on the di agnosis of osseous and soft tissue sarcomas before treatment.SUVmax of PET/CT can also be applied as a re ference for discriminating high and low grade osseous sarcomas,but should not be used in t he same way for soft tissue sarcomas.