{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:02:18Z","timestamp":1784682138486,"version":"3.55.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009399","name":"Peking University Third Hospital","doi-asserted-by":"crossref","award":["BYSYDL2023003"],"award-info":[{"award-number":["BYSYDL2023003"]}],"id":[{"id":"10.13039\/501100009399","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Systematic data on\n                      <jats:sup>18<\/jats:sup>\n                      F-fluorodeoxyglucose positron emission tomography\/computed tomography (\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG PET\/CT) in metastatic chordoma are scarce. This study aimed to evaluate its imaging characteristics and potential relevance to clinical assessment and management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center retrospective analysis, 21 patients with pathologically confirmed chordoma and prior treatment underwent\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG PET\/CT for suspected recurrence or metastasis. Metastatic disease was diagnosed per a composite standard (biopsy, imaging progression, or characteristic multimodal findings). Relevant clinical and histopathological data were collected. Images were independently reviewed by two experienced nuclear medicine physicians for metabolic activity and whole-body disease assessment. They assessed metabolic activity at the primary site and performed whole-body evaluation. For each metastatic lesion, maximum standardized uptake value (SUVmax) and size were measured; CT features were also documented. Interobserver agreement for key assessments was formally evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Metastatic disease was identified in 11 of 21 patients (52.4%). Metastases were found in bone (7 patients), soft tissue (8 patients), and lung (5 patients). Site-specific metabolic patterns emerged: pulmonary metastases had lower FDG avidity (median SUVmax 2.3) correlated with size, whereas bone and soft-tissue avidity (SUVmax 3.8\u20133.9) was size-independent. Notably, in 4 out of 21 patients (19.0%), PET\/CT detected metastases outside the field of view of conventional imaging. Interobserver agreement was perfect for metastatic status and excellent for total lesion counts. A case illustrated differential treatment response linked to baseline metabolic avidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG PET\/CT offers a reproducible whole-body assessment for chordoma, enabling the detection of occult metastases and revealing metabolic heterogeneity of potential clinical relevance. These hypothesis-generating findings suggest a potential role in surveillance and personalized management, warranting further prospective validation before clinical implementation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02444-7","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:35:16Z","timestamp":1779795316000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["18F\u2011FDG PET\/CT in metastatic chordoma: a retrospective analysis of imaging features and potential clinical relevance"],"prefix":"10.1186","volume":"26","author":[{"given":"Le","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peilin","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"2444_CR1","doi-asserted-by":"crossref","unstructured":"Walcott BP, Nahed BV, Mohyeldin A, Coumans JV, Kahle KT, Ferreira MJ. Chordoma: current concepts, management, and future directions. Lancet Oncol. 2012:e69\u201376.","DOI":"10.1016\/S1470-2045(11)70337-0"},{"key":"2444_CR2","doi-asserted-by":"crossref","unstructured":"Akiyama T, Ogura K, Gokita T, Tsukushi S, Iwata S, Nakamura T, et al. Analysis of the infiltrative features of chordoma: the relationship between micro-skip metastasis and postoperative outcomes. Ann Surg Oncol. 2018:912\u20139.","DOI":"10.1245\/s10434-017-6268-6"},{"key":"2444_CR3","doi-asserted-by":"crossref","unstructured":"Chang C, Chebib I, Torriani M, Bredella M. Osseous metastases of chordoma: imaging and clinical findings. Skeletal Radiol. 2017:351\u20138.","DOI":"10.1007\/s00256-016-2566-5"},{"key":"2444_CR4","first-page":"16","volume":"509","author":"R Kishimoto","year":"2012","unstructured":"Kishimoto R, Omatsu T, Hasegawa A, Imai R, Kandatsu S, Kamada T. Imaging characteristics of metastatic chordoma. Jpn J Radiol. 2012;509:16.","journal-title":"Jpn J Radiol"},{"key":"2444_CR5","doi-asserted-by":"crossref","unstructured":"Shi Q, Guo W, Yu S, Xu J, Ji T, Tang X. Clinical characteristics and predisposing factors of lung metastasis in sacral chordoma: a cross-sectional cohort study of 221 cases. Front Oncol. 2024:1416331.","DOI":"10.3389\/fonc.2024.1416331"},{"key":"2444_CR6","doi-asserted-by":"crossref","unstructured":"Stacchiotti S, Casali PG, Lo Vullo S, Mariani L, Palassini E, Mercuri M, et al. Chordoma of the mobile spine and sacrum: a retrospective analysis of a series of patients surgically treated at two referral centers. Ann Surg Oncol. 2010:211\u20139.","DOI":"10.1245\/s10434-009-0740-x"},{"key":"2444_CR7","doi-asserted-by":"crossref","unstructured":"Berlucchi S, Nasi D, Zunarelli E, Valluzzi A, Alicandri Ciufelli M, Presutti L, et al. Cutaneous metastasis from cervical spinal chordoma: case report and literature review. World Neurosurg. 2020:296\u2013303.","DOI":"10.1016\/j.wneu.2020.02.018"},{"key":"2444_CR8","doi-asserted-by":"crossref","unstructured":"Figliozzi S, Stankowski K, Monti L, Francone M. Multiparametric cardiovascular magnetic resonance characterization of a rare chordoma metastasis to the heart. Eur Heart J Cardiovasc Imaging. 2025:1075.","DOI":"10.1093\/ehjci\/jeaf040"},{"key":"2444_CR9","doi-asserted-by":"crossref","unstructured":"Sekmen S, Hursoy N, Gucer H, Burakgazi G, Balik MS, Cubukcu SS. Muscle metastasis from cervical chordoma: a case report. Skeletal Radiol. 2025:1331\u20136.","DOI":"10.1007\/s00256-024-04780-7"},{"key":"2444_CR10","doi-asserted-by":"crossref","unstructured":"Stef\u00e0no PL, Barletta G, Andrei V, Cerillo AG, Nesi G, Pilato G, et al. Cardiac metastasis of sacral chordoma. Ann Thorac Surg. 2021:e319\u201321.","DOI":"10.1016\/j.athoracsur.2020.07.093"},{"key":"2444_CR11","doi-asserted-by":"crossref","unstructured":"Cui F, Su M, Zhang H, Tian R. Humeral metastasis of sacrococcygeal chordoma detected by fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography: A case report. Radiol Case Rep. 2018:449\u201352.","DOI":"10.1016\/j.radcr.2018.01.026"},{"key":"2444_CR12","doi-asserted-by":"crossref","unstructured":"Collins GR, Essary L, Strauss J, Hino P, Cockerell CJ. Incidentally discovered distant cutaneous metastasis of sacral chordoma: a case with variation in S100 protein expression (compared to the primary tumor) and review of the literature. J Cutan Pathol. 2012:637\u201343.","DOI":"10.1111\/j.1600-0560.2012.01895.x"},{"key":"2444_CR13","doi-asserted-by":"crossref","unstructured":"Kinoshita T, Okudera T, Shimosegawa E, Yoshida Y, Yasui N, Ogawa T, et al. Chordoma with postoperative subcutaneous implantation and meningeal dissemination: MRI. Neuroradiology. 2001:763-6.","DOI":"10.1007\/s002340100563"},{"key":"2444_CR14","doi-asserted-by":"crossref","unstructured":"Fernandes Cabral DT, Zenonos GA, Fernandez-Miranda JC, Wang EW, Gardner PA. Iatrogenic seeding of skull base chordoma following endoscopic endonasal surgery. J Neurosurg. 2018:947\u201353.","DOI":"10.3171\/2017.6.JNS17111"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-026-02444-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02444-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02444-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:17:09Z","timestamp":1784679429000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12880-026-02444-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2444"],"URL":"https:\/\/doi.org\/10.1186\/s12880-026-02444-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8715079\/v1","asserted-by":"object"}]},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"28 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted as per the Declaration of Helsinki. The approval to the protocol was done by the Ethics Committee of Peking University Third Hospital and each regulation was followed. The requirement for informed consent was waived by the board due to the retrospective nature of the study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"366"}}