Abstract
Objective
To systematically review and meta-analyse literature data on the diagnostic performance of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) in patients with Ewing sarcoma family tumours (ESFT).
Materials and methods
PubMed/MEDLINE, Embase and Scopus databases were searched for articles that evaluated FDG-PET and PET/CT in patients with ESFT from inception to 31 May 2011. Studies that fulfilled the three following criteria were included in the systematic review: FDG-PET or PET/CT performed in patients with ESFT; articles about the diagnostic accuracy of FDG-PET and PET/CT; sample size of at least 10 patients with ESFT were included. Studies in which there were sufficient data to reassess sensitivity and specificity of FDG-PET or PET/CT in ESFT were included in the meta-analysis, excluding duplicate publications. Finally, pooled sensitivity, pooled specificity and area under the receiver operating characteristic (ROC) curve of FDG-PET or PET/CT in ESFT were calculated.
Results
We found 13 studies comprising a total of 342 patients with ESFT. The main findings of the studies included are presented. The meta-analysis of five selected studies provided these results about FDG-PET and PET/CT in ESFT: pooled sensitivity: 96% (95% confidence interval [CI] 91–99%); pooled specificity: 92% (95% CI 87–96%); area under the ROC curve: 0.97.
Conclusion
With regard to the staging and restaging of patients with ESFT, the sensitivity, specificity and accuracy of FDG-PET and PET/CT are high; the combination of FDG-PET or PET/CT with conventional imaging is a valuable tool for the staging and restaging of ESFT and has a relevant impact on the treatment strategy plan.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ludwig JA. Ewing sarcoma: historical perspectives, current state-of-the-art, and opportunities for targeted therapy in the future. Curr Opin Oncol. 2008;20:412–8.
Bestic JM, Peterson JJ, Bancroft LW. Use of FDG PET in staging, restaging, and assessment of therapy response in Ewing sarcoma. Radiographics. 2009;29:1487–501.
Lakkaraju A, Patel CN, Bradley KM, Scarsbrook AF. PET/CT in primary musculoskeletal tumours: a step forward. Eur Radiol. 2010;20:2959–72.
Treglia G, Cason E, Fagioli G. Recent applications of nuclear medicine in diagnostics (first part). Ital J Med. 2010;4:84–91.
Zamora J, Abraira V, Muriel A, Khan K, Coomarasamy A. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol. 2006;6:31.
Franzius C, Sciuk J, Daldrup-Link HE, Jürgens H, Schober O. FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy. Eur J Nucl Med. 2000;27:1305–11.
Daldrup-Link HE, Franzius C, Link TM, Laukamp D, Sciuk J, Jürgens H, et al. Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET. AJR Am J Roentgenol. 2001;177:229–36.
Franzius C, Daldrup-Link HE, Sciuk J, Rummeny EJ, Bielack S, Jürgens H, et al. FDG-PET for detection of pulmonary metastases from malignant primary bone tumors: comparison with spiral CT. Ann Oncol. 2001;12:479–86.
Franzius C, Daldrup-Link HE, Wagner-Bohn A, Sciuk J, Heindel WL, Jürgens H, et al. FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging. Ann Oncol. 2002;13:157–60.
McCarville MB, Christie R, Daw NC, Spunt SL, Kaste SC. PET/CT in the evaluation of childhood sarcomas. AJR Am J Roentgenol. 2005;184:1293–304.
Györke T, Zajic T, Lange A, Schäfer O, Moser E, Makó E, et al. Impact of FDG PET for staging of Ewing sarcomas and primitive neuroectodermal tumours. Nucl Med Commun. 2006;27:17–24.
Kneisl JS, Patt JC, Johnson JC, Zuger JH. Is PET useful in detecting occult nonpulmonary metastases in pediatric bone sarcomas? Clin Orthop Relat Res. 2006;450:101–4.
Völker T, Denecke T, Steffen I, Misch D, Schönberger S, Plotkin M, et al. Positron emission tomography for staging of pediatric sarcoma patients: results of a prospective multicentre trial. J Clin Oncol. 2007;25:5435–41.
Tateishi U, Yamaguchi U, Seki K, Terauchi T, Arai Y, Kim EE. Bone and soft-tissue sarcoma: preoperative staging with fluorine 18 fluorodeoxyglucose PET/CT and conventional imaging. Radiology. 2007;245:839–47.
Gerth HU, Juergens KU, Dirksen U, Gerss J, Schober O, Franzius C. Significant benefit of multimodal imaging: PET/CT compared with PET alone in staging and follow-up of patients with Ewing tumors. J Nucl Med. 2007;48:1932–9.
Charest M, Hickeson M, Lisbona R, Novales-Diaz JA, Derbekyan V, Turcotte RE. FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases. Eur J Nucl Med Mol Imaging. 2009;36:1944–51.
Mody RJ, Bui C, Hutchinson RJ, Yanik GA, Castle VP, Frey KA, et al. FDG PET imaging of childhood sarcomas. Pediatr Blood Cancer. 2010;54:222–7.
Vrachimis A, Dirksen U, Wessling J, Wenning C, Stegger L, Franzius C, et al. PET surveillance of patients with Ewing sarcomas of the trunk: must the lower legs be included? Nuklearmedizin. 2010;49:183–6.
Conflicts of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Treglia, G., Salsano, M., Stefanelli, A. et al. Diagnostic accuracy of 18 F-FDG-PET and PET/CT in patients with Ewing sarcoma family tumours: a systematic review and a meta-analysis. Skeletal Radiol 41, 249–256 (2012). https://doi.org/10.1007/s00256-011-1298-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-011-1298-9