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FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging
C Franzius1, H E Daldrup-Link, A Wagner-Bohn
1Department of Nuclear Medicine, University Hospital, Münster, Germany. franziu@uni-muenster.de
Background:
The aim of this study was to assess the diagnostic ability of positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG-PET) in the detection of recurrences from malignant primary bone tumors compared with conventional imaging.
Patients And Methods:
In 27 patients (6 osteosarcomas, 21 Ewing's sarcomas), 41 FDG-PET examinations performed for diagnosis or exclusion of recurrent disease were evaluated. Conventional imaging techniques consisted of magnetic resonance imaging of the primary tumor site, thoracic computed tomography, and Tc-99m methylene diphosphonate bone scintigraphy. The reference methods were the histopathological analysis and/or the clinical and imaging follow-up.
Results:
In 25 examinations reference methods revealed 52 sites of recurrent disease (local n = 7; distant: osseous n = 22, pulmonary n = 13, soft tissue n = 10). On an examination-based analysis FDG-PET had a sensitivity of 0.96, a specificity of 0.81 and an accuracy of 0.90. Corresponding values for conventional imaging were 1.0, 0.56 and 0.82.
Conclusions:
The sensitivity, specificity and accuracy of FDG-PET in the detection of recurrences from osseous sarcomas are high. On an examination-based analysis, FDG-PET had a not significantly lower sensitivity in comparison with conventional imaging. However, FDG-PET showed a small advantage in the detection of osseous and soft-tissue recurrences compared with conventional imaging.