Advances in the Molecular Imaging of Sarcoma: An Emphasis on Metabolic Imaging.

Purpose: Sarcomas, malignancies of mesenchymal origin, present significant diagnostic and therapeutic challenges due to their heterogeneity and low incidence. This review aims to examine the evolving role of fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the management of soft tissue and musculoskeletal sarcomas. Specifically, it seeks to evaluate 18F-FDG PET/CT's utility in detecting metastatic lesions, differentiating benign from malignant tumors, and assessing treatment responses.

Procedures: A comprehensive review of the literature was conducted to analyze advancements in PET imaging for sarcomas. Emphasis was placed on 18F-FDG PET/CT's role in complementing conventional imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI). Key aspects of PET imaging in musculoskeletal and cardiac tumors were examined, including its sensitivity and specificity in identifying metastases and its metabolic characterization of various tumor types.

Results: 18F-FDG PET/CT has demonstrated high sensitivity and specificity in detecting metastatic sarcoma lesions and grading musculoskeletal tumors, such as osteosarcoma, chondrosarcoma, and Ewing sarcoma. Its ability to provide metabolic insights has enhanced differentiation between benign and malignant tumors, including myxomas, lipomas, angiosarcomas, and leiomyosarcomas. Furthermore, in primary and secondary cardiac tumors, 18F-FDG PET/CT has proven valuable for treatment planning by offering detailed metabolic characterization.

Conclusions: 18F-FDG PET/CT serves as a critical imaging modality in the diagnosis, staging, and treatment monitoring of sarcomas. By complementing conventional imaging techniques, it enhances the accuracy of tumor characterization and facilitates improved clinical decision-making. Its application in both musculoskeletal and cardiac sarcomas underscores its growing significance in oncologic imaging, making it a valuable tool in optimizing patient outcomes.