Usama Ibrahim Salem MBBCh, MSC, Presenter: Nothing to Disclose

Behrang Amini MD, PhD, Abstract Co-Author: Nothing to Disclose

Hubert H. Chuang MD, PhD, Abstract Co-Author: Nothing to Disclose

Najat C. Daw MD, Abstract Co-Author: Nothing to Disclose

Wei Wei, Abstract Co-Author: Nothing to Disclose

Colleen Mary Costelloe MD, Abstract Co-Author: Nothing to Disclose

Tamara Miner Haygood MD, PhD, Abstract Co-Author: Nothing to Disclose

John E. Madewell MD, Abstract Co-Author: Nothing to Disclose

The existing literature of 18 F-FDG PET/CT in Ewing sarcoma investigates heterogeneous populations of patients with both soft tissue and bone primary tumors. The aim of our study was to evaluate whether the maximum standardized uptake value (SUV (max)) using 18 F-FDG PET/CT before and after initiation of chemotherapy, can be used as an indicator of survival in patients with primary Ewing sarcoma of bone.

A retrospective database search was conducted from 2004 - 2011 and 178 patients with pathologically proven bone primary Ewing sarcoma were identified. Patients who received treatment before the initial PET/CT or underwent PET/CT at other institutions were excluded. Twenty-nine patients underwent 18 F-FDG PET/CT before and after starting chemotherapy at our institution. The study included 10 females and 19 males, with a median age of 18 years. One female patient was excluded from the analysis because she underwent partial tumor resection before the initial PET/CT as a symptomatic treatment to relieve nerve compression. Median follow up time for patients alive was 6.2 years (range: 2.6-9.8 years). Univariate Cox proportional hazard model was used to assess effects of baseline SUV (max), post-chemo SUV (max), and the change of SUV (max) on overall survival (OS) and progression-free survival (PFS). OS started from chemo start date, and PFS started from post-chemo PET/CT date.

SUV max ranged from 37-2.2 with a median of 8.7 for baseline and from 16.6-1.4 with a median of 3.2 post chemotherapy. High SUV (max) before (HR = 1.1, 95% CI: 1.0-1.2, P = 0.008) and after (HR =1.2, 95% CI: 1.0-1.4, P = 0.04) chemotherapy was associated with worse overall survival. No significant cut points for SUV (max) were identified.

Baseline and post chemotherapy SUV (max) can be used as a prognostic indicator for overall survival in bone primary Ewing sarcoma. 

18F-FDG PET/CT can be used as a prognostic indicator of overall survival in bone primary Ewing sarcoma. 

Salem, U, Amini, B, Chuang, H, Daw, N, Wei, W, Costelloe, C, Haygood, T, Madewell, J, 18F-FDG PET/CT as an Indicator of Survival in Bone Primary Ewing Sarcoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014409.html