Related Experiment Video
Updated: May 22, 2026
10:28
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
18 F-FDG PET/CT Derived Volumetric Parameters Can Predict Outcome in Pediatric Ewing Sarcoma
Başak Soydaş-Turan1,2, Bilge Volkan-Salancı3, Burça Aydın4
1Department of Nuclear Medicine, Kastamonu Education and Research Hospital, Kastamonu, Türkiye. basaksoydas@hotmail.com.
Annals of Nuclear Medicine
|May 21, 2026
Summary
Baseline metabolic tumor volume (MTV) predicts survival in pediatric Ewing sarcoma (EWS). Total lesion glycolysis (TLG) predicts metastatic presentation. Combining MTV and histologic response offers complementary prognostic insights.
Area of Science:
- Nuclear Medicine
- Pediatric Oncology
- Radiomics
Background:
- 18F-FDG PET/CT is crucial for staging and assessing treatment response in pediatric Ewing sarcoma (EWS).
- Metabolic and volumetric parameters from PET scans may offer prognostic information beyond traditional metrics.
- Understanding these parameters' predictive value can aid in risk stratification and personalized treatment strategies for EWS.
Purpose of the Study:
- To evaluate the prognostic and predictive capabilities of baseline and post-chemotherapy 18F-FDG PET/CT metabolic and volumetric parameters in pediatric EWS patients.
- To assess the association of these PET parameters with histopathologic response, metastatic status, overall survival (OS), and progression-free survival (PFS).
- To determine the independent prognostic value of specific PET-derived metrics like metabolic tumor volume (MTV) and total lesion glycolysis (TLG).
Main Methods:
- Retrospective analysis of 55 pediatric EWS patients undergoing baseline 18F-FDG PET/CT (PET1), with 24 also having post-chemotherapy scans (PET2).
- Calculation of SUVmax, SUVpeak, MTV, and TLG using various absolute and relative thresholds, alongside anatomic tumor volume.
- Correlation of PET parameters with histopathologic response (available in 40/18 patients for PET1/PET2) using logistic and Cox regression models.
Main Results:
- Baseline PET metabolic and volumetric parameters were significantly elevated in patients with metastatic EWS.
- Total lesion glycolysis (TLG) at 45% threshold was the sole independent predictor of metastatic presentation (OR=1.026, p=0.019).
- Baseline metabolic tumor volume (MTV) at 2.0 threshold independently predicted shorter OS (HR=1.026, p=0.003) and PFS (HR=1.035, p=0.038).
- Combination of MTV (2.0) and histologic response improved prognostic stratification, with low MTV showing better survival even with unfavorable histology.
- PET parameters did not reliably predict histopathologic response in this cohort.
Conclusions:
- Baseline MTV (2.0) is a significant prognosticator for OS and PFS in pediatric EWS.
- TLG (45%) independently predicts metastatic EWS presentation.
- The integration of MTV (2.0) and histologic response provides complementary prognostic information, suggesting potential for refined risk stratification in EWS management.
