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[Positron-emission tomography of the skeletal system using 18FNa: the incidence, pattern of the findings and
H Schirrmeister1, J Kotzerke, M Rentschler
1Abteilung für Nuklearmedizin, Universität Ulm.
Purpose:
We evaluated the frequency, distribution and appearance of benign lesions in 18F-PET scans.
Methods:
Between March 1996 and May 1997, 18F-PET scans were performed in 59 patients in addition to conventional planar bone scintigraphy. Eleven patients were subjected to additional SPECT imaging. The main indication was searching for bone metastases (58 pat.). The diagnosis was confirmed radiologically.
Results:
With 18F-PET in 39 patients (66.1%) 152 benign lesions, mostly located in the spine were detected. 99mTc bone scans revealed 45 lesions in 10 patients. Osteoarthritis of the intervertebral articulations (69%) or of the acromioclavicular joint (15%) were the most common reasons for degenerative lesions detected with 18F-PET. Osteophytes appeared as hot lesions located at two adjacent vertebral endplates. Osteoarthritis of the intervertebral articulations showed an enhanced tracer uptake at these localizations, whereas endplate fractures of the vertebral bodies appeared very typical; solitary fractures of the ribs could not be differentiated from metastases. Rare benign lesions were not studied.
Conclusion:
Most of the degenerative lesions (84%) detected with 18F-PET had a very typical appearance and could be detected with the improved spatial resolution and advantages of a tomographic technique. 18F-PET had an increased accuracy in detecting degenerative bone lesions.