Utility of FDG-PET in differential diagnosis of benign and malignant fractures in acute to subacute phase.
OBJECTIVE
To evaluate the usefulness of positron emission tomography with [fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG-PET) for early differential diagnosis of benign and malignant fractures.


METHODS
Among 1,164 patients who had received FDG-PET between January 1999 and December 2000, 20 patients were found to have an acute fracture on review of clinical charts and/or radiologic images taken within one month before or after FDG-PET examination. The fractures were finally diagnosed by clinical follow up of at least five months duration. Standardized uptake values (SUV) for the benign and malignant bone lesions were calculated and compared.


RESULTS
Ten of the 20 patients were finally diagnosed to have a benign fracture, nine patients to have a malignant fracture, and one patient to have both a benign and a malignant fracture at different locations. A statistically significant difference in the SUV was found between the benign group (SUV: 1.36 +/- 0.49) and the malignant group (SUV: 4.46 +/- 2.12) (p = 0.0006, the nonparametric Mann-Whitney U test).


CONCLUSIONS
FDG-PET can be a useful method for early differentiation between acute benign and metastatic fractures. Our retrospective study indicates that an acute benign fracture itself does not show significant FDG uptake.
Kato
Katsuya
K
Department of Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Japan. katoukatsuya@hotmail.com
Aoki
Jun
J
Endo
Keigo
K
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D050723:Fractures, Bone / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D005598:Fractures, Spontaneous / Q000145:classification* / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014055:Tomography, Emission-Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18