[Is FDG TEP CT practice changing in the management of sarcomas in adults?]

FDG PET (PET)±computed tomography (CT) has increasingly been used in some areas of oncology imaging. It is sometimes performed outside recommendations, at diagnosis or monitoring of sarcomas. We assessed the value of PET-CT in routine practice in sarcomas.

All consecutive sarcoma adult patient charts presented at the multidisciplinary sarcoma meeting in a tertiary care center over a period of 10months were examined in order to analyze the performances of PET-CT when available.

Of 232 patients, 50 (21 %) underwent a PET-CT. Sensitivity and specificity of PET-CT were 94.7 %, 57.1 %, respectively. SUV values were highly variable, including for a given histology or grade. PET-CT resulted in practice changing in 14 % of cases. When extrapulmonary metastases are suspected and for some subtypes of sarcomas, PET-CT could provide additional information because in view of its good sensitivity.

Given the most frequent pulmonary tropism, first hand chest CT may be sufficient at first diagnostic work-up for the detection of pulmonary metastases. However, the relatively poor specificity suggests that further analyses should be performed to identify clinical situations where PET-CT may be of added value compared to current standards.