title: Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma.
abstract: OBJECTIVE
  We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma.
  
  
  METHODS
  We retrospectively reviewed 206 patients with stage II-IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated.
  
  
  RESULTS
  Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98%, respectively, for PET/CT; 76, 97, and 96%, respectively, for BS; and 100, 96, and 97%, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100%) was significantly higher than that of PET/CT (92%) or BS (74%) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77%).
  
  
  CONCLUSIONS
  PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity.
authors.affiliation: Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul, 139-706, Republic of Korea, nmbbh@hanmail.net.
authors.forename: Byung Hyun
authors.initials: BH
authors.lastname: Byun
authors.forename: Chang-Bae
authors.initials: CB
authors.lastname: Kong
authors.forename: Ilhan
authors.initials: I
authors.lastname: Lim
authors.forename: Byung Il
authors.initials: BI
authors.lastname: Kim
authors.forename: Chang Woon
authors.initials: CW
authors.lastname: Choi
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Song
authors.forename: Wan Hyeong
authors.initials: WH
authors.lastname: Cho
authors.forename: Dae-Geun
authors.initials: DG
authors.lastname: Jeon
authors.forename: Jae-Soo
authors.initials: JS
authors.lastname: Koh
authors.forename: Soo-Yong
authors.initials: SY
authors.lastname: Lee
authors.forename: Sang Moo
authors.initials: SM
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D012516:Osteosarcoma / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate