title: 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors.
abstract: BACKGROUND
  F-Fluoro-2-deoxy-D: -glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children.
  
  
  OBJECTIVE
  To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors.
  
  
  METHODS
  Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology.
  
  
  RESULTS
  A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV(max) and greater SUV(max) reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement.
  
  
  CONCLUSIONS
  PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy.
authors: Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia. kevinL5@chw.edu.au
authors: Kevin
authors: K
authors: London
authors: Claudia
authors: C
authors: Stege
authors: Siobhan
authors: S
authors: Cross
authors: Ella
authors: E
authors: Onikul
authors: Nicole
authors: N
authors: Graf
authors: Gertjan
authors: G
authors: Kaspers
authors: Luciano
authors: L
authors: Dalla-Pozza
authors: Robert
authors: R
authors: Howman-Giles
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007223:Infant; D008297:Male; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18