The role of F-18-FDG PET/CT in abdominal and pelvic leiomyosarcoma: a literature review

Purpose Abdominopelvic leiomyosarcoma (LMS) is a rare soft tissue sarcoma of smooth muscle, becoming usually manifest with a compressive effect on adjacent structures. A biopsy sample is necessary to obtain the definitive diagnosis. F-18-fluorodeoxyglucose positron emission computed tomography (F-18-FDG PET/CT), showing the most glucose-avid part of the tumor, can be useful in improving biopsy accuracy. Moreover, it seems to have a role in providing prognostic information and in distinguishing between high- and low-grade disease. The purpose of our study is to review current literature to summarize the emerging role of F-18-FDG PET/CT in abdominopelvic LMS. Methods PubMed/MEDLINE database was screened to find articles regarding the role of F-18-FDG PET/CT in abdominopelvic LMS in different clinical settings (staging, restaging, treatment response, post-therapy surveillance). Terms "leiomyosarcoma" AND ("PET" OR "positron emission tomography") were used. Results Eight studies exploring the role of F-18-FDG PET/CT in abdominal and pelvic LMS patients were included. Different clinical settings and study aims were reported. A semiquantitative analysis of PET results was assessed in all included studies in addition to qualitative analysis, when performed. Data regarding F-18-FDG PET/CT diagnostic performance and imaging reference standard for validation of PET findings were reported in 3/8 and in 8/8 studies, respectively. The prognostic role of F-18-FDG PET/CT in LMS was analyzed in 3/5 studies; worse prognosis was reported for higher values of PET parameters. Conclusion Although additional studies are needed, F-18-FDG PET/CT seems to be a potential useful diagnostic tool in the clinical management of abdominopelvic LMS patients.