Association of Tumor [18F]FDG Activity and Diffusion Restriction with Clinical Outcomes of Rhabdomyosarcomas

Arian Pourmehdi Lahiji, Tatianie Jackson, Hossein Nejadnik, Rie von Eyben, Daniel Rubin, Sheri L. Spunt, Andrew Quon, Heike Daldrup-Link

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Purpose: To evaluate whether the extent of restricted diffusion and 2-deoxy-2-[18F] fluoro-d-glucose ([18F]FDG) uptake of pediatric rhabdomyosarcomas (RMS) on positron emission tomography (PET)/magnetic resonance (MR) images provides prognostic information. Procedure: In a retrospective, IRB-approved study, we evaluated [18F]FDG PET/CT and diffusion-weighted (DW) MR imaging studies of 21 children and adolescents (age 1–20 years) with RMS of the head and neck. [18F]FDG PET and DW MR scans at the time of the initial tumor diagnosis were fused using MIM software. Quantitative measures of the tumor mass with restricted diffusion, [18F]FDG hypermetabolism, or both were dichotomized at the median and tested for significance using Gray’s test. Data were analyzed using a survival analysis and competing risk model with death as the competing risk. Results: [18F]FDG PET/MR images demonstrated a mismatch between tumor areas with increased [18F]FDG uptake and restricted diffusion. The DWI, PET, and DWI + PET tumor volumes were dichotomized at their median values, 23.7, 16.4, and 9.5 cm3, respectively, and were used to estimate survival. DWI, PET, and DWI + PET overlap tumor volumes above the cutoff values were associated with tumor recurrence, regardless of post therapy COG stage (p = 0.007, p = 0.04, and p = 0.07, respectively). Conclusion: The extent of restricted diffusion within RMS and overlap of hypermetabolism plus restricted diffusion predict unfavorable clinical outcomes.

Original languageEnglish (US)
Pages (from-to)591-598
Number of pages8
JournalMolecular Imaging and Biology
Volume21
Issue number3
DOIs
StatePublished - Jun 17 2019
Externally publishedYes

Keywords

  • Diffusion-weighted MR
  • PET/MR
  • Rhabdomyosarcoma
  • [F]FDG

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Fingerprint

Dive into the research topics of 'Association of Tumor [18F]FDG Activity and Diffusion Restriction with Clinical Outcomes of Rhabdomyosarcomas'. Together they form a unique fingerprint.

Cite this