title: Is there a need for dedicated bone imaging in addition to 18F-FDG PET/CT imaging in pediatric sarcoma patients?
abstract: OBJECTIVE
  Many children with sarcomas undergo whole body 2-deoxy-2-((18)F)fluoro-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and technetium methylene diphosphonate ((99)Tc-MDP) studies. It is unknown whether the combination of both tests results in more accurate detection of bone lesions than (18)F-FDG- PET/CT alone.
  
  
  METHODS
  (99)Tc-MDP bone and (18)F-FDG PET/CT scans were each read by 2 "blinded" observers and then reviewed side-by-side by 3 readers. Bone lesions were graded qualitatively on a 5-point scale (from benign to malignant). Clinical and imaging follow-up (n = 21) and bone biopsy results (n = 8) served as reference standard.
  
  
  RESULTS
  A total of 39 paired (99)Tc-MDP and (18)F-FDG-PET/CT studies (cases) performed at a mean interval 4 ± 7 days, were performed on 29 patients (mean age 12 ± 5 y). Of these, 21 patients (72%) had bone sarcoma, whereas 8 patients (28%) had soft tissue sarcoma. By patient and case-based analysis, (18)F-FDG PET/CT had an accuracy of 100%. Tc-MDP had accuracies of 90% and 82% by patient and case-based analysis. The combined interpretation had an accuracy of 97%.
  
  
  CONCLUSIONS
  In this study, (99)Tc-MDP bone imaging does not provide an added diagnostic value for bone involvement over (18)F-FDG-PET/CT.
authors: Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA 90095, USA.
authors: Franziska
authors: F
authors: Walter
authors: Johannes
authors: J
authors: Czernin
authors: Theodore
authors: T
authors: Hall
authors: Martin
authors: M
authors: Allen-Auerbach
authors: Martin A
authors: MA
authors: Walter
authors: Simone
authors: S
authors: Dunkelmann
authors: Noah
authors: N
authors: Federman
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging*; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate