Comparison of fluorine-18-FDG PET and technetium-99m-MIBI SPECT in evaluation of musculoskeletal sarcomas.
We compared the diagnostic accuracy of [18F]FDG PET and 99mTc-MIBI SPECT in musculoskeletal sarcomas.


METHODS
Forty-eight patients with clinically suspected recurrent or residual musculoskeletal sarcomas were examined with both FDG-PET and MIBI-SPECT within 2 wk of each study (one follow-up study in nine patients and we follow-up studies in one patient). Imaging findings were visually inspected with grading scales in conjunction with CT and/or MRI, and count-density ratios of lesion-to-contralateral area and standard uptake values (SUVs) of FDG and MIBI in lesions were also generated. The results were correlated with histologic findings (in 51 studies) and/or long-term follow-up evaluations.


RESULTS
The diagnostic sensitivities and specificities were 98% and 90% using FDG, and 81.6% and 80% using MIBI, respectively, with statistical significance in the sensitivity. The tumors were demonstrated better in FDG studies, which produced higher visual grades (2.1 versus 1.6), and the tumors showed increasing SUVs with time (from 6.3 to 7.3). Four of nine patients with positive FDG but negative MIBI scans failed to respond to multidrug therapy.


CONCLUSIONS
FDG-PET and MIBI-SPECT are useful in differentiating active sarcomas from post-treatment changes and in evaluating therapeutic response. MIBI-SPECT and FDG-PET findings should be interpreted in con junction with CT and/or MRI. FDG-PET shows statistically significant higher sensitivity than MIBI-SPECT. A positive FDG but negative MIBI scan might suggest a multidrug resistance.
Garcia
R
R
Department of Nuclear Medicine, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Kim
E E
EE
Wong
F C
FC
Korkmaz
M
M
Wong
W H
WH
Yang
D J
DJ
Podoloff
D A
DA
D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D018365:Neoplasm, Residual; D012509:Sarcoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi; D003847:Deoxyglucose