Zhu YL, Sun YW, Ge YC, He J, Li RT. Advances in 18F-fluorodeoxyglucose positron emission tomography/computed tomography for soft tissue sarcomas. World J Radiol 2025; 17(7): 106427 [DOI: 10.4329/wjr.v17.i7.106427]
Corresponding Author of This Article
Jian He, MD, PhD, Associate Professor, Chief Physician, Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Drum Tower Clinical Medical College, Nanjing Medical University, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China. hjxueren@126.com
Research Domain of This Article
Nuclear Science & Technology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jul 28, 2025; 17(7): 106427 Published online Jul 28, 2025. doi: 10.4329/wjr.v17.i7.106427
Advances in 18F-fluorodeoxyglucose positron emission tomography/computed tomography for soft tissue sarcomas
Yan-Lin Zhu, Yi-Wen Sun, Yu-Chen Ge, Jian He, Ru-Tian Li
Yan-Lin Zhu, Yi-Wen Sun, Jian He, Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, Jiangsu Province, China
Yu-Chen Ge, Ru-Tian Li, The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
Co-first authors: Yan-Lin Zhu and Yi-Wen Sun.
Co-corresponding authors: Jian He and Ru-Tian Li.
Author contributions: He J and Zhu YL conceived the idea for the manuscript; Zhu YL reviewed the literature and drafted the manuscript; Sun YW and Ge YC provided comprehensive perspectives; He J and Li RT revised and finalized the manuscript, and contributed equally as co-corresponding authors; and all authors have read and approved the final version of the manuscript. Justification for Co-Corresponding Authorship: He J and Li RT qualify as co-corresponding authors due to their indispensable, complementary, and equally critical leadership roles throughout the development and completion of this manuscript. He J was instrumental in originating the core concept of the manuscript and provided overarching intellectual guidance and supervision across all stages of the project. He spearheaded the critical revision process, ensuring the manuscript's scientific rigor, structural coherence, and alignment with the original research vision, ultimately playing the lead role in finalizing the content for submission. Li RT made pivotal contributions to the intellectual framing and scholarly depth of the work. She led the comprehensive revision efforts, focusing on enhancing theoretical synthesis, contextualizing findings within the broader literature, and refining the manuscript's narrative flow and academic impact. Her expertise was crucial in shaping the final version to meet high publication standards. The synergistic collaboration between He J and Li RT – combining He J's foundational conceptualization and strategic oversight with Li RT's profound analytical refinement and scholarly articulation – was fundamental to the successful preparation and completion of this manuscript. Both authors share equal responsibility for correspondence and the overall integrity of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian He, MD, PhD, Associate Professor, Chief Physician, Department of Nuclear Medicine, Nanjing Drum Tower Hospital, Drum Tower Clinical Medical College, Nanjing Medical University, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China. hjxueren@126.com
Received: February 26, 2025 Revised: April 26, 2025 Accepted: July 16, 2025 Published online: July 28, 2025 Processing time: 149 Days and 20.3 Hours
Abstract
Soft tissue sarcomas (STS) are rare malignant tumors originating from mesodermal tissues with a poor prognosis, accounting for approximately 1% of all malignancies and comprising around 50 distinct subtypes. Conventional imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), primarily provide anatomical information, whereas 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) integrates functional metabolic and anatomical imaging, serving as a critical complementary tool in the diagnosis and management of STS. This article reviews recent advances in the application of 18F-FDG PET/CT for STS. The advantages of 18F-FDG PET/CT in STS include: (1) Early detection of metabolic activity changes in tumors, particularly when morphological alterations are insignificant; (2) Effective differentiation between benign and malignant soft tissue tumors, as well as aiding in distinguishing high-grade from low-grade sarcomas; (3) Identification of occult metastatic lesions, improving staging accuracy, and facilitating restaging in cases of recurrence or metastasis; (4) Utilization of parameters such as maximum standardized uptake value and metabolic tumor volume to assist in tumor grading and prognostic evaluation; and (5) Monitoring treatment response to guide adjustments in personalized therapeutic strategies. However, 18F-FDG PET/CT has limitations in diagnosis of certain STS subtypes (e.g., myxoid liposarcoma), detection and biopsy of metastatic lymph nodes, necessitating integration with clinical evaluation and other imaging techniques. 18F-FDG PET/CT is poised to play an increasingly vital role in the precision diagnosis and treatment of STS.
Core Tip:18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), which integrates both anatomical and metabolic imaging, provides comprehensive, accurate, and valuable information for clinical practice in soft tissue sarcomas (STS) safely and non-invasively. It has demonstrated significant advantages in various aspects of STS management, including diagnosis, tumor grading and staging, guidance for biopsy site selection, evaluation of treatment response, monitoring of recurrence and metastasis, and prognostic assessment. Therefore, 18F-FDG PET/CT can serve as a complementary tool to conventional imaging modalities such as computed tomography, magnetic resonance imaging, and bone scans.
