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International Journal of Surgical Oncology
Volume 2016, Article ID 6162182, 7 pages
http://dx.doi.org/10.1155/2016/6162182
Review Article

The Role of [18F]FDG-PET/CT in Predicting Malignant Transformation of Plexiform Neurofibromas in Neurofibromatosis-1

1Westmead Hospital, Cnr Hawkesbury and Darcy Rd, Westmead, NSW 2145, Australia
2University of Sydney, Camperdown, NSW, Australia
3Nuclear Medicine, Westmead Children’s Hospital, Westmead, NSW, Australia

Received 15 August 2016; Revised 15 November 2016; Accepted 21 November 2016

Academic Editor: Vahit Ozmen

Copyright © 2016 David Tovmassian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Malignant peripheral nerve sheath tumours (MPNSTs) are difficult to diagnose and treat and contribute to significant morbidity and mortality for patients with Neurofibromatosis-1 (NF-1). FDG-PET/CT is being increasingly used as an imaging modality to discriminate between benign and malignant plexiform neurofibromas. Objectives. To assess the value of FDG-PET/CT in differentiating between benign and malignant peripheral nerve lesions for patients with Neurofibromatosis-1. Methods. A systematic review of the literature was performed prior to application of stringent selection criteria. Ultimately 13 articles with 796 tumours were deemed eligible for inclusion into the review. Results. There was a significant difference between mean of benign and malignant lesions (1.93 versus 7.48, resp.). Sensitivity ranged from 89 to 100% and specificity from 72 to 94%. ROC analysis was performed to maximise sensitivity and specificity of cut-off; however no clear value was identified (range 3.1–6.1). Significant overlap was found between the of benign and malignant lesions making differentiation of lesions difficult. Many of the studies suffered from having a small cohort and from not providing histological data on all lesions which underwent FDG-PET/CT. Conclusion. This systematic review is able to demonstrate that FDG-PET/CT is a useful noninvasive test for discriminating between benign and malignant lesions but has limitations and requires further prospective trials.