Functional imaging techniques for evaluation of sarcomas

The Centre for Molecular Imaging, The Peter MacCallum Cancer Centre, Melbourne, Australia.
Cancer Imaging (Impact Factor: 2.07). 02/2005; 5(1):58-65. DOI: 10.1102/1470-7330.2005.0007
Source: PubMed


Sarcomas are often characterised by significant histopathologic heterogeneity, both between and within tumours. This heterogeneity reflects physiologic, biochemical and genetic processes that are amenable to characterisation by functional imaging. Although anatomically based imaging modalities such as plain radiography, X-ray computed tomography (CT) and magnetic resonance imaging (MRI) remain the primary diagnostic modalities for staging sarcomas, nuclear medicine approaches including gamma camera scintigraphy and positron emission tomography (PET) are being used increasingly to provide complementary information in specific clinical situations. These include biopsy guidance within anatomically complex masses, staging, therapeutic response assessment and evaluation of residual mass lesions after treatment. This review aims to address the range of nuclear medicine techniques available for evaluation of bone and soft tissue sarcomas. A subsequent review discusses the clinical application of these techniques with a particular focus on PET.

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    • "It has been reported that PVNS demonstrates high isotope accumulation (26), although little has been reported about the scintigraphic findings of the disease (27). While a low retention rate of Tl-201 on delayed imaging is observed in benign tumors (28), Tl-201 uptake is observed on early and delayed images in almost all cases of PVNS (26,29); this simulates the findings of malignant disease (29). Given the above findings, the presence of activity on Tl-201 scintigraphy alone does not aid in the differentiation of PVNS from malignant diseases. "
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    ABSTRACT: Pigmented villonodular synovitis (PVNS) arising from the elbow joint is extremely rare; only 24 cases have been reported. It is extremely difficult to differentiate PVNS from other soft tissue tumors on the basis of imaging findings alone. Therefore, a biopsy is required for definitive diagnosis. A 20-year-old female reported a mass on her right elbow. Physical examination revealed a tumor measuring 3.0x3.0 cm. Magnetic resonance imaging (MRI) revealed that the signal intensity of the tumor was isointense to muscle on T1-weighted images; however, it was hyper- or isointense to muscle on T2-weighted images. In images obtained by gadolinium-enhanced MRI, the margin of the tumor was well-contrasted. Thallium (Tl)-201 scintigrams revealed an abnormal accumulation in the area of the mass in the early and delayed phases. On the basis of clinical findings, imaging characteristics and incision biopsy results, localized PVNS was diagnosed and marginal excision was performed. We thus identified an extremely rare case of PVNS arising from the elbow joint. When interpreting Tl-201 images for the assessment of bone and soft tissue lesions, it is important to recognize PVNS as a condition that simulates malignant tumors. Furthermore, PVNS should be considered in the differential diagnosis when increased Tl-201 activity is closely related to the joint. MRI aids in the differentiation by demonstrating features of hemosiderin degradation products. These findings are likely to be extremely helpful in the differential diagnosis of bone and soft tissue tumors.
    Experimental and therapeutic medicine 05/2013; 5(5):1277-1280. DOI:10.3892/etm.2013.1022 · 1.27 Impact Factor
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    • "Soft tissue sarcomas represent the majority of sarcomas that occur in adults. Treatment response imaging for this group of patients is emerging [23] [24] [25] [26] [27]. In an early study, in an extremity soft tissue sarcoma group treated with adriamycin based neoadjuvant chemotherapy, Schuetze et al. showed that separating patients by their 18 F-FDG response Figure 2. FDG PET/CT images of a patient with a neurofibrosarcoma in the right neck base. "
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    ABSTRACT: Sarcomas are a biologically complex group of diseases that exhibit variable responses to single or combination therapy. (18)F-FDG PET imaging contributes to sarcoma treatment response assessment as an objective semiquantitative biomarker of response. In this review, background and experience in (18)F-FDG PET as a biomarker that successfully identifies tumor response is assessed.
    American Journal of Nuclear Medicine and Molecular Imaging 01/2011; 1(1):47-53. · 3.25 Impact Factor
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    • "Curative treatment approaches almost always include surgery but a combination of surgery with adjuvant radiotherapy [1] or systemic chemotherapy [2] [3] is now an integral component of the multidisciplinary care of many sarcoma patients. There is a wide range of nuclear medicine techniques that can be used to characterise biological characteristics of bone and soft tissue sarcomas [4] . "
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    ABSTRACT: A wide range of molecular imaging techniques are available that can provide complementary information to conventional, anatomical imaging for the evaluation of known or suspected bone and soft tissue sarcomas. In particular, positron emission tomography (PET), particularly in the form of hybrid PET/CT technology, offers many potential advantages over current imaging approaches by delineating not only the extent of disease but also the biological heterogeneity that can exist both between and within sarcomas. This review discusses the clinical situations where nuclear medicine techniques can aid in the management of patients with sarcoma. These include biopsy guidance, whole body staging, therapeutic response assessment and evaluation of residual mass lesions after treatment.
    Cancer Imaging 02/2005; 5(1):66-72. DOI:10.1102/1470-7330.2005.0008 · 2.07 Impact Factor
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