title: The accuracy of [(18)F]fluorodeoxyglucose positron emission tomography as confirmed by biopsy in the diagnosis of spine metastases in a cancer population.
abstract: OBJECTIVE
  To determine the accuracy of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the diagnosis of vertebral metastases in patients with cancer using needle-biopsy results and patient follow-up data.
  
  
  METHODS
  A retrospective chart review of all patients who underwent a needle biopsy of a spinal lesion and underwent FDG-PET within 6 weeks of the biopsy was performed. Biopsy results and magnetic resonance imaging and computed tomographic appearance of the biopsied lesion, as well as long-term clinical follow-up data, were recorded for each patient. A total of 82 patients with solid tumors and hematological spine metastases were included in this study.
  
  
  RESULTS
  The mean standardized uptake values of lesions with active cancer were 7.1 and 2.1 in benign lesions (P < 0.02). In patients with metastatic solid tumors, the mean standardized uptake value was 7.3. Stratification of solid tumor lesions according to whether they had a sclerotic appearance on computed tomographic scans showed that FDG-PET was a significantly better predictor of cancer status in lytic or mixed lesions. In patients with a history of solid tumors, there was 100% concordance between the FDG-PET and needle-biopsy diagnoses in nonsclerotic lesions, when the standardized uptake value cutoff of 2 was used.
  
  
  CONCLUSIONS
  FDG-PET is an accurate screening test for vertebral metastases in cancer patients. It is especially accurate in patients with nonsclerotic vertebral lesions and a history of solid malignancy.
authors.affiliation: Department of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: Ilya
authors.initials: I
authors.lastname: Laufer
authors.forename: Eric
authors.initials: E
authors.lastname: Lis
authors.forename: Leszek
authors.initials: L
authors.lastname: Pisinski
authors.forename: Timothy
authors.initials: T
authors.lastname: Akhurst
authors.forename: Mark H
authors.initials: MH
authors.lastname: Bilsky
mesh_terms: D001707:Biopsy, Needle; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18