FDG-PET for detection of pulmonary metastases from malignant primary bone tumors: comparison with spiral CT.
BACKGROUND
The purpose was the comparison of positron emission tomography using F-18-fluorodeoxy-glucose (FDG-PET) and spiral thoracic CT to detect pulmonary metastases from malignant primary osseous tumors.


METHODS
In 71 patients with histologically confirmed malignant primary bone tumors (32 osteosarcomas, 39 Ewing's sarcomas) 111 FDG-PET examinations were evaluated with regard to pulmonary/pleural metastases in comparison with spiral thoracic CT. Reference methods were the clinical follow-ups for 6-64 months (median 20 months) or a histopathologic analysis.


RESULTS
In 16 patients (23%) reference methods revealed a pulmonary/pleural metastatic disease. FDG-PET had a sensitivity of 0.50, a specificity of 0.98, and an accuracy of 0.87 on a patient based analysis. Comparable values for spiral CT were 0.75, 1.00, and 0.94. It was shown that no patient who had a true positive FDG-PET had a false negative CT scan, nor was a pulmonary metastases detected earlier by FDG-PET than by spiral CT.


CONCLUSIONS
There seems to be a superiority of spiral CT in the detection of pulmonary metastases from malignant primary bone tumors as compared with FDG-PET. Therefore, at present a negative FDG-PET cannot be recommended to exclude lung metastases. However, as specificity of FDG-PET is high, a positive FDG-PET result can be used to confirm abnormalities seen on thoracic CT scans as metastatic.
Franzius
C
C
Department of Nuclear Medicine, University Hospital, Münster, Germany. franziu@uni-muenster.de
Daldrup-Link
H E
HE
Sciuk
J
J
Rummeny
E J
EJ
Bielack
S
S
Jürgens
H
H
Schober
O
O
D000293:Adolescent; D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D013902:Radiography, Thoracic; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000556:secondary; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18