Metabolic Tumor Volume by ¹⁸F-FDG PET/CT Can Predict the Clinical Outcome of Primary Malignant Spine/Spinal Tumors

Figure 5

Representative case presentation of and metabolic parameters in large and heterogeneous cervical spinal tumor. A spinal MPNST in a 40-year-old man. (a) The mass was 9 cm in size and the axial T2-weighted MRI showed mixed intense signal mass with unclear boundary in epidural and paravertebral space. (b) A preoperative ¹⁸F-FDG PET/CT scan was obtained and the tumor showed moderate (5.25 g/mL). (c) For calculations of metabolic parameters, a volume-of-interest was drawn on the PET images (light blue area). A preset threshold of 2.5 of SUV of the tumor was used to define the MTV (84.3 mL) and the mean SUV of the MTV was determined ( 3.06 SUV). MTV and were used to calculate the TLG (258 SUVml). The patient underwent a partial resection of the epidural tumor and carbon-ion radiotherapy. Five months after surgery, multiple bone (d) and lung metastasis (e) were detected and the patient died 9 months after surgery.

(a)

(b)

(c)

(d)

(e)