FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging.
BACKGROUND
The aim of this study was to assess the diagnostic ability of positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG-PET) in the detection of recurrences from malignant primary bone tumors compared with conventional imaging.


METHODS
In 27 patients (6 osteosarcomas, 21 Ewing's sarcomas), 41 FDG-PET examinations performed for diagnosis or exclusion of recurrent disease were evaluated. Conventional imaging techniques consisted of magnetic resonance imaging of the primary tumor site, thoracic computed tomography, and Tc-99m methylene diphosphonate bone scintigraphy. The reference methods were the histopathological analysis and/or the clinical and imaging follow-up.


RESULTS
In 25 examinations reference methods revealed 52 sites of recurrent disease (local n = 7; distant: osseous n = 22, pulmonary n = 13, soft tissue n = 10). On an examination-based analysis FDG-PET had a sensitivity of 0.96, a specificity of 0.81 and an accuracy of 0.90. Corresponding values for conventional imaging were 1.0, 0.56 and 0.82.


CONCLUSIONS
The sensitivity, specificity and accuracy of FDG-PET in the detection of recurrences from osseous sarcomas are high. On an examination-based analysis, FDG-PET had a not significantly lower sensitivity in comparison with conventional imaging. However, FDG-PET showed a small advantage in the detection of osseous and soft-tissue recurrences compared with conventional imaging.
Franzius
C
C
Department of Nuclear Medicine, University Hospital, Münster, Germany. franziu@uni-muenster.de
Daldrup-Link
H E
HE
Wagner-Bohn
A
A
Sciuk
J
J
Heindel
W L
WL
Jürgens
H
H
Schober
O
O
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D018213:Neoplasms, Bone Tissue / Q000175:diagnosis* / Q000473:pathology; D012008:Recurrence; D014055:Tomography, Emission-Computed / Q000379:methods*
D019788:Fluorodeoxyglucose F18