Synovial sarcoma generally is associated with poor prognosis. With recent advances in molecular biology, it has become apparent
not all synovial sarcomas share the same tumor biology.
18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is useful for risk assessment in several types of sarcomas. We
therefore assessed the clinical value of
18F-FDG-PET-derived maximum standard uptake value (SUV
max) for predicting survival in patients with synovial sarcoma.
18F-FDG-PET was performed in 44 patients with synovial sarcoma before therapy and resection. SUV
max was calculated for each tumor and then evaluated for prognostic usefulness along with metastasis at presentation, tumor grade,
histopathologic subtype, age, gender, postsurgical margins, anatomic location, and tumor size for overall survival and progression-free
survival. SUV
max ranged from 1.2 to 13.0 (median, 4.35). Pretherapy tumor SUV
max predicted overall survival and progression-free survival. Patients presenting with a SUV
max greater than 4.35 had a decreased disease-free survival and were therefore at high risk for having local recurrences and
metastatic disease.
Level of Evidence: Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
One or more of the authors (JFE) have received funding from National Institutes of Health/National Cancer Institute Grant
RO1 CA 65537.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.