Advances in 18F-fluorodeoxyglucose positron emission tomography/computed tomography for soft tissue sarcomas

Table 1 Landmark Studies Establishing ¹⁸F-fludeoxyglucose positron emission tomography computed tomography value in soft tissue sarcoma management

Ref.	Study design	Sample size	Key findings	Clinical significance
Singh et al[59], 2021	Prospective cohort	40 patients	SUVmax significantly correlated with tumor grade and overall survival (P < 0.001)	First quantification of metabolic parameters for prognostic stratification
Liu et al[60], 2018	Multicenter retrospective	195 patients	Diagnostic accuracy of 89.2% across 44 histologic subtypes	Validated universal utility of PET/CT in rare STS subtypes
Metser et al[25], 2023	Multicenter prospective	304 patients	Altered clinical management in 45% of patients; 37% improvement in staging accuracy	Largest evidence supporting PET/CT-guided decision-making in STS
Chodyla et al[61], 2021	Prospective cohort	52 patients	MTV > 150 cm³ associated with 4.6-fold higher metastasis risk (HR = 4.6, P = 0.001)	Established pretreatment risk stratification model using volumetric parameters
Annovazzi et al[27], 2020	Prospective study	37 patients	Sensitivity 92% and specificity 89% for recurrence detection	Gold-standard evidence for PET/CT in surveillance protocols
Chen et al[62], 2017	Meta-analysis	9 studies	Each 1-unit SUVmax increase predicted 18% higher mortality risk	The first evidence-based medical evidence for survival prediction
Sakir et al[63], 2025	Retrospective study	45 patients	Texture analysis outperformed SUVmax in DFS prediction (AUC = 0.82 vs 0.68)	Pioneered radiomics-based prognostic models in STS
Harrison et al[23], 2017	Pediatric cohort study	58 patients	Detected 89% of occult metastases	Established PET/CT as standard for pediatric STS staging
Reyes Marlés et al[15], 2021	Retrospective analysis	83 patients	TLG > 300 predicted 2-year PFS (P = 0.003)	First integrated metabolic-volume prognostic model
Wu et al[64], 2022	Novel tracer comparison	1 patients	68Ga-FAPI demonstrated 3-fold higher sensitivity than 18F-FDG	Highlighted potential of next-generation tracers for STS characterization

¹⁸F-FDG PET/CT: ¹⁸F-fludeoxyglucose positron emission tomography computed tomography; STS: Soft tissue sarcoma; SUVmax: Maximum standardized uptake value; MTV: Metabolic tumor volume; TLG: Total lesion glycolysis.