Starting from these premises, we designed the current study to investigate whether the patterns of FDG uptake corresponding to areas of coagulative tumor cell necrosis on PET images can be helpful in distinguishing between LMS/STUMP and benign leiomyomas during the preoperative period.
A specific PET imaging parameter termed "metabolic tumor/necrosis ratio" was developed to quantify the presence of coagulative tumor cell necrosis in LMS/STUMP (Figure 1(a)) and calculated with an automated approach (Figure 1(b)) as follows:
Because the presence of coagulative tumor cell necrosis is an essential diagnostic criterion for LMS/STUMP , we reasoned that a PET-derived metabolic parameter reflecting coagulative tumor necrosis would be extremely helpful for the presurgical identification of LMS/STUMP.
A recent study evaluating the potential role of biomarkers in differentiating ischemic from coagulative tumor cell necrosis was conducted by Yang and Mutter.
The distinction of early infarct necrosis from coagulative tumor cell necrosis can be challenging in this setting, as it is in patients treated with embolization.