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FDG PET predicts outcome in osteosarcomas

Society of Nuclear Medicine

Los Angeles, California... FDG PET is a powerful prognostic tool in predicting outcomes for patients with osteosarcoma, a form of bone cancer that often affects children, according to a study presented at the 49th Annual Meeting of the Society of Nuclear Medicine (SNM) in Los Angeles. The authors noted that this finding could change the course of therapy offered and that the individualized assessment provided by PET may improve chances of event-free survival among children with the disease.

Christiane Franzius and colleagues from the Department of Nuclear Medicine at the University of Münster, Germany, used PET to evaluate the prognostic significance of 18F-fluorodeoxyglucose (FDG) uptake in primary osteosarcomas. FDG uptake was measured by PET in 29 patients (ages 5-41) who had been diagnosed with primary osteosarcoma. The patients then underwent chemotherapy and surgery of their primary tumor sites. Their clinical course was followed for a median of 28 months, and the authors found that the higher the initial FDG uptake in tumor, the poorer was the prognosis.

"The prognosis for a patient with osteosarcoma is always dependent on the therapy they undergo," said Dr. Franzius. "PET identifies patients at first diagnosis of the disease who may have a poor prognosis with the therapy usually prescribed. These patients can then be treated more aggressively. In additional studies we hope to determine whether such therapy intensification actually improves outcomes for patients identified at diagnosis with high FDG uptake on PET."

Despite its relative rarity, cancer is the chief cause of death by disease in children ages 1-14 in the United States. Between 500 to 1000 new cases of osteosarcoma occur in the United States each year, most in children and adolescents. Although the 5-year survival rate is about 73%, individual survival is dependent upon the stage at diagnosis and the aggressiveness of therapy and intervention.

Positron emission tomography (PET) is a diagnostic imaging test that measures metabolic activity and generates images of organ or tissue function. FDG is the key radiopharmaceutical used in PET because, when injected, it is "taken up" more rapidly by tumor than by healthy tissue. This allows physicians to identify not only the spread of the tumor in the body but also functional characteristics, such as biological aggressiveness.

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The Society of Nuclear Medicine Annual Meeting is being held June 15-19 at the Los Angeles Convention Center, Los Angeles, CA. In addition to educational sessions, the meeting will focus on leading medical developments in the field of nuclear medicine, including radioimmunotherapy with a new class of drugs that target cancer, diagnostic breakthroughs with PET, and other topics. More than 5,000 specialists in the field of nuclear medicine, including scientists, technologists, researchers, and representatives from the medical industry, are expected to attend. The Society of Nuclear Medicine is an international scientific and professional organization with more than 13,000 members dedicated to promoting the science, technology, and practical applications of nuclear medicine. The SNM is based in Reston, VA.

For late-breaking news about the world of nuclear medicine and events at the 49th Annual Society of Nuclear Medicine meeting, visit www.snm.org

Abstract 128. Sunday, June 16, 12:55-1:10 p.m. Room 407
Prognostic Significance of 18F-FDG Uptake in Primary Osteosarcomas
C. Franzius, S. Bielack, S. Flege, J. Sciuk, H. Juergens, O. Schober
University Hospital Münster
Münster, Germany

Abstract No. 128
PROGNOSTIC SIGNIFICANCE OF 18F-FDG UPTAKE IN PRIMARY OSTEOSARCOMAS
C. Franzius*, S. Bielack, S. Flege, J. Sciuk, H. Juergens, O. Schober, University Hospital Münster, Münster, Germany; Department of Nuclear Medicine, University of Münster, Münster, Germany. (200926)
Objective: The purpose of this retrospective analysis was to evaluate the prognostic significance of the initial glucose metabolism as measured by positron emission tomography with 18F-flourodeoxyglucose (FDG PET) in osteosarcoma. Patients and Methods: In 29 patients (aged 5 to 41 years; 18 male, 11 female) with primary osteosarcomas FDG uptake was measured semi-quantitatively using PET (average and maximum tumor/non-tumor ratios (T/NTav, T/NTmax), n = 29; standardized uptake values (SUVav, SUVmax), n = 9) at the time of diagnosis. After chemotherapy the patients had surgery of their primary tumor sites, and response was determined histologically according to Salzer-Kuntschik. Cumulative overall and event-free survival was determined by clinical and imaging follow-up for 7 to 72 months (median, 28 months). Results: Clinical and imaging follow-up revealed a relapse of disease in nine patients, and six patients died of the disease. Both overall and event-free survival were significantly better in patients with low FDG T/NTmax values (

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