The prognostic value of baseline EARL standardized FDG PET indices in pediatric and adolescent high-grade osteosarcoma

• DOI: 10.1007/s00330-025-11372-z
• Publication Date: 2025-01-24T11:42:35Z
• Authors: Roelof van Ewijk; Rana Dandis; Janna Rodewijk; Bart de Keizer; Simone A. J. ter ...; Michiel A. J. van...; Lizz van der Heijden; Johannes H. M. Merks; Lianne M. Haveman; Arthur J. A. T. B...
• Keywords: Standardized uptake value; Cut-off; Log-rank test; Neuroradiology

Abstract Objective To investigate the prognostic value of baseline European Association Nuclear Medicine Research Ltd. (EARL) standardized [ 18 F]fluorodeoxyglucose positron emission tomography-computed tomography ([ F]FDG PET-CT) quantitative values for survival and to evaluate cutoff identified in other studies. Materials methods Pediatric adolescent patients with high-grade osteosarcoma were included. Baseline PET-CT, EARL-accredited reconstructions, was standard diagnostic staging procedure. Cox proportional hazard analysis event-free (EFS) overall (OS) performed clinical factors. Kaplan–Meier log-rank tests applied performance PET indices. Results In total, 66 included this study. univariable regression analysis, peak lean-body mass corrected SUV (SUL ) (hazard ratio (HR): 1.04), total lesion glycolysis (TLG) (HR: 1.0), metabolic tumor volume (MTV) 1.0) not associated EFS or OS. Log-rank showed a significant difference all SUL max cutoffs. For MTV maximum Youden, TLG Youden maximally selected rank resulted difference. No any measure OS between groups. ROC curves event status had an AUC 0.67, 0.66, 0.64, 0.64 , respectively. Conclusion study, EARL-standardized indices children adolescents The proposed cutoffs from earlier studies suffer important technical statistical issues. Key Points Question Prognostic PET-CT imaging markers have been reported histologic response but validated practice. Findings measured on reconstructions factors pediatric osteosarcoma. Clinical relevance A wide range similar identified, questioning single cutoff. Lack validation, issues cutoffs, limits implementation.