Application of 18F-FDG PET metabolic parameters in evaluating histopathologic grading of soft tis-sue sarcoma
Objective To evaluate the value of 18F-FDG PET metabolic parameters in predicting histopathological grade of soft tissue sarcoma(STS).Methods From December 2012 to December 2021,51 patients(26 males,25 females,age range:32-84 years)who underwent 18F-FDG PET/CT imaging be-fore treatment and confirmed STS pathologically in the First Affiliated Hospital of Dalian Medical University were retrospectively collected.18F-FDG PET metabolic parameters SUVmax,metabolic tumor volume(MTV),total lesion glycolysis(TLG)and intertumoral FDG uptake heterogeneity(IFH)were measured.Kruskal-Wallis rank sum test was used to analyze the differences in metabolic parameters among different groups and Spearman rank correlation analysis was used to analyze the correlation of each metabolic parame-ter and histological grade.Logistic regression was used to screen and construct the prediction model for high-grade STS.ROC curve was plotted and Delong test was used to analyze the differences among AUCs.Results The metabolic parameters SUVmax,MTV,TLG and IFH were significantly different among French Federation of Cancer Centers Sarcoma Group(FNCLCC)Ⅰ(n=8),Ⅱ(n=10)and Ⅲ(n=33)grade groups(H values:16.24,10.52,19.29 and 16.99,all P＜0.05),and each metabolic parameter was positively correlated with histo-logical grade(rs values:0.58,0.45,0.52,and 0.62,all P＜0.05).Multivariate logistic regression analysis showed that SUVmax(odds ratio(0R)=1.27,95％CI:1.06-1.51,P=0.009)and IFH(OR=6.83,95％CI:1.44-32.27,P=0.015)were independent risk indicators for high-grade STS.The prediction model constructed by combining SUVmax and IFH had better diagnostic efficacy for differentiating high-grade STS with the AUC of 0.93,and the sensitivity of 93.9％(31/33)and the specificity of 16/18,respectively.The AUC of predic-tion model was significant different from SUVmax,MTV,TLG and IFH(AUCs:0.81,0.78,0.86 and 0.85;z values:2.69,2.53,1.94 and 1.97,all P＜0.05).Conclusions The metabolic parameters SUVmax,MTV,TLG and IFH are valuable predictors for histological grade of STS.The combination of SUVmax and IFH may be a more meaningful method than using each of the above metabolic parameters alone.
SarcomaNeoplasm gradingPositron-emission tomographyFluorodeoxyglucose F1 8Forecasting
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