Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press59210.17650/2782-3687-2022-14-4-63-70REAL CLINICAL CASESКЛИНИЧЕСКИЕ СЛУЧАИThe role of positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose in the diagnosis of soft tissue sarcomasРоль позитронной эмиссионной томографии, совмещенной с компьютерной томографией, с 18F-фтордезоксиглюкозой в диагностике сарком мягких тканейhttps://orcid.org/0000-0002-2416-9826KorolevaE. S.КоролеваЕ. С.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

len.kor2020@mail.ruhttps://orcid.org/0000-0003-1632-351XProninA. I.ПронинА. И.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0001-7460-3267MikhailovA. I.МихайловА. И.
Russian Federation

5 2nd Botkinskij proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 5

https://orcid.org/0000-0003-3576-6156OdzharovaA. A.ОджароваА. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-3672-1742SushentsovE. A.СушенцовЕ. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-1396-3434BokhyanB. Y.БохянБ. Ю.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-8476-7879KrylovA. S.КрыловА. С.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииS.P. Botkin City Clinical Hospital of the Ministry of Health of RussiaГБУЗ «Городская клиническая больница им. С.П. Боткина» Минздрава России2212202214463702112202221122022Copyright ©; 2022, Koroleva E.S., Pronin A.I., Mikhailov A.I., Odzharova A.A., Sushentsov E.A., Bokhyan B.Y., Krylov A.S.Copyright ©; 2022, Королева Е.С., Пронин А.И., Михайлов А.И., Оджарова А.А., Сушенцов Е.А., Бохян Б.Ю., Крылов А.С.2022Koroleva E.S., Pronin A.I., Mikhailov A.I., Odzharova A.A., Sushentsov E.A., Bokhyan B.Y., Krylov A.S.Королева Е.С., Пронин А.И., Михайлов А.И., Оджарова А.А., Сушенцов Е.А., Бохян Б.Ю., Крылов А.С.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/592

Soft tissue sarcoma are here, heterogeneous malignant neoplasms that present difficulties in diagnosis, treatment and follow-up. High-quality diagnostic planning allows timely decision-making on further tactics of patient management in a particular case. Positron emission tomography with a biological analogue of glucose – 18F-fluorodeoxyglucose, combined with computed tomography, is an imaging tool that measures the metabolic activity of a tumor and is increasingly used in clinical practice to assess primary tumor tissue, staging, monitoring the effectiveness of treatment and as a method of early detection of relapses. This literature review is aimed at evaluating the usefulness of positron emission tomography combined with computed tomography at different stages of diagnostic control in patients with soft tissue sarcomas.

Саркомы мягких тканей – это редкие гетерогенные злокачественные новообразования, представляющие сложность в диагностике, лечении и последующем наблюдении. Правильное диагностическое планирование позволяет своевременно принять решение о дальнейшей тактике ведения каждого пациента. Позитронная эмиссионная томография, совмещенная с компьютерной томографией, с биологическим аналогом глюкозы 18F-фтордезоксиглюкозой представляет собой инструмент визуализации, измеряющий метаболическую активность опухоли, и широко используется в клинической практике для оценки первичной опухолевой ткани, стадирования, контроля эффективности лечения и как метод раннего выявления рецидивов. Данный обзор литературы посвящен анализу результативности применения позитронной эмиссионной томографии, совмещенной с компьютерной томографией, на разных этапах диагностического контроля пациентов с саркомами мягких тканей.

positron emission tomography combined with computed tomographysoft tissue sarcomas18F-fluorodeoxyglucoseпозитронная эмиссионная томографиясовмещенная с компьютерной томографиейсаркомы мягких тканей18F-фтордезоксиглюкозаRebecca L., Siegel M.H., Kimberly D. et al. Cancer statistics, 2022. CA Cancer J Clini 2022;72(1):7–33. DOI: 10.3322/caac.21708The state of oncological care for the population of Russia in 2021. Ed. by A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. Moscow: P.A. Herzen Moscow State Medical Research Institute – branch of “NMIC of Radiology”, Ministry of Health of Russia, 2022. 239 p. (In Russ.).Состояние онкологической помощи населению России в 2021 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2022. 239 с.Toro J.R., Travis L.B., Wu H.J. et al. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978–2001: an analysis of 26,758 cases. Int J Cancer 2006;119(12);2922–30. DOI: 10.1002/ijc.22239Coindre J.M., Terrier P., Guillou L. et al. Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas. Cancer 2001;91(10);1914–26. DOI: 10.1002/1097-0142(20010515)91:103.0.co;2-3Frank G.A. Problems of morphological classification and diagnosis of soft tissue tumors. Practicheskaya oncologiya = Practical Oncology 2004;5:231–6. (In Russ.).Франк Г.А. Проблемы морфологической классификации и диагностики опухолей мягких тканей. Практическая онкология 2004;5:231–6.Cates J.M.M. The AJCC 8th edition staging system for soft tissue sarcoma of the extremities or trunk: a cohort study of the SEER database. J Natl Compr Cancer Netw 2018;16(2):144–52. DOI: 10.6004/jnccn.2017.7042Clinical recommendations for the diagnosis and treatment of patients with soft tissue sarcoma. Clinical recommendations of the All-Russian Union of Public. (In Russ.). Available at: https://oncology-association. ru/wp-content/uploads/2020/09/sarkoma_mjagkih_tkanej.pdf.Клинические рекомендации по диагностике и лечению больных саркомой мягких тканей. Клинические рекомендации Общероссийского союза общественных объединений Ассоциации онкологов России. 2020. Доступно по: https://oncology-association.ru/ wp-content/uploads/2020/09/sarkoma_mjagkih_tkanej.pdf.Skytting B., Meis-Kindblom J.M., Larsson O. et al. Synovial sarcoma – identification of favorable and unfavorable histologic types: a Scandinavian sarcoma group study of 104 cases. Acta Orthop Scand 1999;70(6);543–54. DOI: 10.3109/17453679908997840Improving outcomes for people with sarcoma. Guidance NICE. 2006. Available at: https://www.nice.org.uk/guidance/csg9.Nagano S., Yahiro Y., Yokouchi M. et al. Doppler ultrasound for diagnosis of soft tissue sarcoma: efficacy of ultrasound-based screening score. Radiol Oncol Mar 2015;49(2):135–40. DOI: 10.1515/raon-2015-0011Vibhakar A.M., Cassels J.A., Botchu R. et al. Imaging update on soft tissue sarcoma. J Clin Orthop Trauma 2021;22:101568. DOI: 10.1016/j.jcot.2021.101568Roberts C.C., Kransdorf M.J., Beaman F.D. et al. ACR appropriateness Criteria follow-up of malignant or aggressive musculoskeletal tumors. J Am Coll Radiol 2016;13(4):389–400. DOI: 10.1016/j.jacr.2015.12.019Bar-Shalom R., Valdivia A.Y., Blaufox M.D. et al. PET imaging in oncology. Semin Nucl Med 2000;30(3):150–85. DOI: 10.1053/snuc.2000.7439Sarikaya I., Sarikaya A. Assessing PET parameters in oncologic 18F-FDG studies. J Nucl Med Technol 2020;48(3):278–82. DOI:10.2967/jnmt.119.236109Younis M.H., Abu-Hijleh H.A., Aldahamsheh O.O. et al. Meta-analysis of the diagnostic accuracy of primary bone and soft tissue sarcomas by 18F-FDG-PET. Med Princ Pract 2020;29(5):465–72. DOI: 10.1159/000505651Chen L., Wu X., Ma X. et al. Prognostic value of 18F-FDG PET-CTbased functional parameters in patients with soft tissue sarcoma: a meta-analysis. Medicine 2017;96(6):5913. DOI: 10.1097/MD.0000000000005913Hui J.Y. Epidemiology and etiology of sarcomas. Surgical clinics 2016;96(5):901–14. DOI: 10.1016/j.suc.2016.05.005Etchebehere E.C., Hobbs B.P., Milton D.R. et al. Assessing the role of 18F-FDG PET and 18F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2016;43(5):860–70. DOI: 10.1007/s00259-015-3242-zMacpherson R.E., Pratap S., Tyrrell H. et al. Retrospective audit of 957 consecutive 18F-FDG PET-CT scans compared to CT and MRI in 493 patients with different histological subtypes of bone and soft tissue sarcoma. Clin Sarcoma Res 2018;8:9. DOI:10.1186/s13569-018-0095-9Rakheja R., Makis W., Skamene S. et al. Correlating metabolic activity on 18F-FDG PET/CT with histopathologic characteristics of osseous and soft-tissue sarcomas: a retrospective review of 136 patients. Am J Roentgenol 2012;198(6):1409–16. DOI:10.2214/ajr.11.7560Katal S., Gholamrezanezhad A., Kessler M. et al. PET in the diagnostic management of soft tissue sarcomas of musculoskeletal origin. PET Clin 2018;13(4):609–21. DOI:10.1016/j.cpet.2018.05.011Schulte M., Brecht-Krauss D., Hamer B. et al. Fluorodeoxyglucose positron emission tomography of soft tissue tumors: is noninvasive determination of biological activity possible? Eur J Nucl Med 1999;26(6):599–605. DOI: 10.1007/s002590050427Gabriel M., Rubello D. 18F-FDG PET-CT in soft tissue sarcomas. Nucl Med Commun 2015;37(1):3–8. DOI:10.1097/mnm.0000000000000407Hain S.F., O’Doherty M.J., Bingham J. et al. Can FDG PET be used to successfully direct preoperative biopsy of soft tissue tumours? Nucl Med Commun 2003;24(11):1139–43. DOI: 10.1097/00006231-200311000-00003Fuglø H.M., Jørgensen S.M., Loft A. et al. The diagnostic and prognostic value of 18F-FDG PET/CT in the initial assessment of highgrade bone and soft tissue sarcoma. Eur J Nucl Med Mol Imaging 2012;39(9):1416–24. DOI: 10.1007/s00259-012-2159-zAnnovazzi A., Rea S., Zoccali C. et al. Diagnostic and clinical impact of 18F-FDG PET/CT in staging and restaging soft-tissue sarcomas of the extremities and trunk: mono-institutional retrospective study of a sarcoma referral center. J Clin Med 2020;9(8):2549. DOI: 10.3390/jcm9082549Noebauer-Huhmann I.M., Weber M.A., Lalam R.K. et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol 2015;19(5):475–82. DOI: 10.1055/s-0035-1569251Roberge D., Vakilian S., Alabed Y.Z. et al. FDG PET/CT in initial staging of adult soft-tissue sarcoma. Sarcoma 2012;2012:960194. DOI:10.1155/2012/960194Hagi T., Nakamura T., Sugino et al. Is FDG-PET/CT useful for diagnosing pulmonary metastasis in patients with soft tissue sarcoma? Anticancer Res 2018;38(6):3635–9. DOI: 10.21873/anticanres.12638Keung E.Z., Chiang Y.J., Voss R.K. et al. Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma. Eur J Surg Oncol 2018;44(1):170–7. DOI: 10.1016/j.ejso.2017.11.014Lim H.J., Johnny Ong C.A., Tan J.W. et al. Utility of positron emission tomography/computed tomography (PET/CT) imaging in the evaluation of sarcomas: a systematic review. Crit Rev Oncol Hematol 2019;143: 1–13. DOI:10.1016/j.critrevonc.2019.07.002Tanaka K., Ogawa G., Mizusawa J. et al. Prospective comparison of various radiological response criteria and pathological response to preoperative chemotherapy and survival in operable high-grade soft tissue sarcomas in the Japan Clinical Oncology Group study JCOG0304. World J Surg Oncol 2018;16(1):1–8. DOI: 10.1186/s12957-018-1462-yGui C., Morris C.D., Meyer C.F. et al. Characterization and predictive value of volume changes of extremity and pelvis soft tissue sarcomas during radiation therapy prior to definitive wide excision. Radiat Oncol J 2019;37(2):117–26. DOI: 10.3857/roj.2018.00549Bludov A.B., Zamogilnaya Ya.A., Nered A.S. et al. Basic principles of dynamic contrast-enhanced magnetic resonance imaging in the evaluation of the preoperative chemotherapy in patients with bone and soft tissue sarcomas. Sarkomy kostej, myagkikh tkanej i opukholi kozhi = Bone and soft tissue sarcomas, tumors of the skin 2011(4):41–50. (In Russ.).Блудов А.Б., Замогильная Я.А., Неред А.С. и др. Основы методики контрастной МРТ в оценке эффективности предоперационной химиотерапии у больных с саркомами костей и мягких тканей. Саркомы костей, мягких тканей и опухоли кожи 2011;4:41–50.Benz M.R., Czernin J., Allen-Auerbach M.S. et al. FDG-PET/CT imaging predicts histopathologic treatment responses after the initial cycle of neoadjuvant chemotherapy in high-grade soft-tissue sarcomas. Clinic Cancer Res 2009;15(8);2856–63. DOI: 10.1158/1078-0432.ccr-08-2537Schuetze S.M., Rubin B.P., Vernon C. et al. Use of positron emission tomography in localized extremity soft tissue sarcoma treated with neoadjuvant chemotherapy. Cancer 2005;103(2):339–48. DOI: 10.1002/cncr.20769.Evilevitch V., Weber W.A., Tap W.D. et al. Reduction of glucose metabolic activity is more accurate than change in size at predicting histopathologic response to neoadjuvant therapy in high-grade soft-tissue sarcomas. Clin Cancer Res 2008;14(3):715–20. DOI: 10.1158/1078-0432.ccr-07-1762Ezuddin N.S., Pretell-Mazzini J., Yechieli R.L. et al. Local recurrence of soft-tissue sarcoma: issues in imaging surveillance strategy. Skeletal Radiol 2018;47(12):1595–606. DOI: 10.1007/s00256-018-2965-xBenz M.R., Crompton J.G., Harder D. PET/CT variants and pitfalls in bone and soft tissue sarcoma. Semin Nucl Med 2021;51(6):584–92. DOI: 10.1053/j.semnuclmed.2021.06.009.Piperkova E., Mikhaeil M., Mousavi A. et al. Impact of PET and CT in PET/CT studies for staging and evaluating treatment response in bone and soft tissue sarcomas. Clin Nucl Med 2009;34(3):146–50. DOI: 10.1097/RLU.0b013e3181966f9dIbraheem A.L., Buck A.K., Benz M.R. et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography for the detection of recurrent bone and soft tissue sarcoma. Cancer 2013;119(6):1227–34. DOI: 10.1002/cncr.27866Ranieri G., Mammi M., Donato E. Pazopanib a tyrosine kinase inhibitor with strong anti-angiogenetic activity: a new treatment for metastatic soft tissue sarcoma. Crit Rev Oncol Hematol 2014;89(2):322–39. DOI: 10.1016/j.critrevonc.2013.08.012Larson S.M., Erdi Y., Akhurst T. et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging. The visual response score and the change in total lesion glycolysis. Clin Positron Imaging 1999;2(3):159–71. DOI: 10.1016/s1095-0397(99)00016-3Choi E.S., Ha S.G., Kim H.S. et al. Total lesion glycolysis by 18F-FDG PET/CT is a reliable predictor of prognosis in soft-tissue sarcoma. Eur J Nucl Med Mol Imaging 2013;40(12):1836–42. DOI: 10.1007/s00259-013-2511-yHong S., Lee S.E., Choi Y.L. et al. Prognostic value of 18F-FDG PET/CT in patients with soft tissue sarcoma: comparisons between metabolic parameters. Skeletal Radiology 2014;43(5):641–8. DOI:10.1007/s00256-014-1832-7Chang K.J., Lim I., Park J.Y. et al. The role of 18F-FDG PET/CT as a prognostic factor in patients with synovial sarcoma. Nucl Med Mol Imaging 2015;49(1):33–41. DOI: 10.1007/s13139-014-0301-5