Clinical contribution of 18F-FDG PET/CT in patients with pediatric bone tissue and soft tissue sarcoma; a retrospective study.
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OBJECTIVE: To assess whether parameters derived from ¹⁸F-FDG PET/CT imaging could be used for prognostic evaluation in pediatric patients with bone and soft tissue sarcomas. MATERIAL AND METHODS: This retrospective study included pediatric patients diagnosed with sarcoma who underwent ¹⁸F-FDG PET/CT between February 2013 and January 2021. A total of 63 patients were evaluated. Anatomical tumor volume, standardized uptake values (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. Progression-free survival (PFS) and overall survival (OS) were calculated. Cox regression analysis was performed to identify independent predictors. RESULTS: The mortality rate was 31.7%, and the median OS was 54.9 months. Lung (p<0.001) and lymph node metastases (p=0.049) were associated with shorter OS. Younger age at diagnosis (p=0.014), higher anatomical tumor volume (p=0.002), and lung metastasis (p=0.004) were independently associated with increased mortality risk. High MTV was independently associated with higher progression risk (p<0.001). CONCLUSION: Anatomical tumor volume and lung metastasis predict mortality, while MTV predicts progression in pediatric sarcoma. Further prospective studies are needed to validate these findings.