Clin Nucl Med. 2024 Sep 25. doi: 10.1097/RLU.0000000000005412. Online ahead of print.
ABSTRACT
PURPOSE: This study aimed to evaluate the ability of 18F-FDG PET/CT metabolic parameters to predict the histological response to neoadjuvant chemotherapy in patients with osteosarcoma and Ewing sarcoma.
PATIENTS AND METHODS: This systematic review and network meta-analysis adhered to the PRISMA-NMA and Cochrane guidelines. Electronic databases were searched from January 2008 to January 2024; this search was supplemented by snowballing methods. The risk of bias was evaluated with QUADAS-2, and evidence certainty was assessed using the GRADE approach. The prognostic value of 18F-FDG PET/CT parameters, including pretreatment and posttreatment SUVs (SUV1, SUV2 and the SUV2/SUV1 ratio), metabolic tumor volume (MTV1, MTV2, ΔMTV), and total lesion glycolysis (TLG1, TLG2, ΔTLG), was examined.
RESULTS: The meta-analysis of 18 studies (714 patients) identified the ΔTLG, ΔMTV, and SUVratio as superior predictors of histological response. The changes in metabolic activity, as indicated by these parameters, provided a robust indication of treatment effectiveness. Baseline parameters showed limited predictive value compared with posttreatment assessments. The study’s robustness was confirmed through meta-regression, which revealed that the predictive value of the SUV2 and SUVratio was consistent across various cutoff thresholds.
CONCLUSIONS: 18F-FDG PET/CT metabolic parameters, particularly those measuring changes posttherapy, are effective in predicting the histological response in patients with osteosarcoma and Ewing sarcoma. These findings underscore the potential of 18F-FDG PET/CT in guiding early treatment decisions, thereby enhancing personalized therapeutic approaches.
PMID:39325490 | DOI:10.1097/RLU.0000000000005412
