F-18-FDG PET-CT in children and young adults with Ewing sarcoma diagnosed in Norway during 2005-2012: a national population-based study

Clin Physiol Funct Imaging. 2016 Nov;36(6):441-446. doi: 10.1111/cpf.12247. Epub 2015 Jun 3.

Abstract

Background: To examine national imaging strategies regarding the use of F-18-FDG PET-CT in patients with Ewing sarcoma and study factors that might influence the use of PET-CT, such as tumour biology (Picci grade of operation specimen), clinical disease stage and age.

Methods: We examined the medical records including pathology and imaging of all patients below 30 years diagnosed with Ewing sarcoma in Norway in 2005-2012.

Results: Of 61 patients treated at one of the two national sarcoma treatment service centres (Oslo: 35, Bergen: 26), 29 patients had localized disease, 8 had tumour extending to organs nearby and 24 had metastases. Among 35 operated patients with neoadjuvant chemotherapy, 15 had Picci grades II and III (good responders) and 20 grade I (poor responders). We found a significant difference in the use of PET-CT (Oslo/Bergen 0·9 versus 2·0 scans per patient, P = 0·010) and in the use of MRI (Oslo/Bergen: eight versus 13, P = 0·006). No differences were proven for ultrasound, radiography, CT or skeletal scintigraphy. The number of PET-CTs was associated with clinical disease stage at diagnosis (P = 0·041) but not with Picci grade or age. The number of PET studies was not correlated to the number of MR studies.

Conclusions: The use of PET-CT in children and young adults diagnosed with Ewing sarcoma in Norway during 2005-2012 at the two national sarcoma treatment service centres differed significantly. The use of PET-CT imaging was related to the clinical disease stage at diagnosis but unrelated to patient age and tumour biology (Picci grade).

Keywords: Ewing sarcoma; magnetic resonance imaging; nuclear medicine imaging; positron-emission tomography; radiologic imaging; skeletal scintigraphy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / pathology
  • Bone Neoplasms / therapy
  • Child
  • Child, Preschool
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage*
  • Healthcare Disparities
  • Humans
  • Male
  • Medical Records
  • Neoplasm Grading
  • Neoplasm Staging
  • Norway
  • Positron Emission Tomography Computed Tomography / statistics & numerical data
  • Positron Emission Tomography Computed Tomography / trends*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Practice Patterns, Physicians' / trends*
  • Predictive Value of Tests
  • Radiopharmaceuticals / administration & dosage*
  • Retrospective Studies
  • Sarcoma, Ewing / diagnostic imaging*
  • Sarcoma, Ewing / secondary
  • Sarcoma, Ewing / therapy
  • Time Factors
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18