PET-CT in the Evaluation of Neoadjuvant/Adjuvant Treatment Response of Soft-tissue Sarcomas: A Comprehensive Review of the Literature.

JBJS Rev · Dec 01 2022 · Review

Castillo-Flores S, Gonzalez MR, Bryce-Alberti M, de Souza F, Subhawong TK, Kuker R, et al.

Division of Orthopedic Oncology, Miami Cancer Institute, Baptist Health System South Florida

Orthopaedic Oncology

SUMMARY — THE REDUCTIONThis review finds PET-CT reliably tracks neoadjuvant treatment response and detects systemic recurrence in soft-tissue sarcomas but has limitations distinguishing benign from malignant uptake and detecting small pulmonary metastases.
Abstract, as published

➢: In soft-tissue sarcomas (STSs), the use of positron emission tomography-computed tomography (PET-CT) through a standardized uptake value reduction rate correlates well with histopathological response to neoadjuvant treatment and survival.

➢: PET-CT has shown a better sensitivity to diagnose systemic involvement compared with magnetic resonance imaging and CT; therefore, it has an important role in detecting recurrent systemic disease. However, delaying the use of PET-CT scan, to differentiate tumor recurrence from benign fluorodeoxyglucose uptake changes after surgical treatment and radiotherapy, is essential.

➢: PET-CT limitations such as difficult differentiation between benign inflammatory and malignant processes, inefficient discrimination between benign soft-tissue tumors and STSs, and low sensitivity when evaluating small pulmonary metastases must be of special consideration.

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