Annals of Oncology 12:479-486, 2001
© 2001 European Society for Medical Oncology
research-article |
FDG-PET for detection of pulmonary metastases from malignant primary bone tumors: Comparison with spiral CT
1Departments of Nuclear Medicine, University Hospital Münster, German
2Departments of Clinical Radiology, University Hospital Münster, German
3Departments of Pediatric Hematology and Oncology, University Hospital Münster, German
Correspondence to: C Franzius, MD, Department of Nuclear Medicine, Münster University, Albert-Schweitzer-Str 33, 48149 Münster, Germany, E-mail franziu{at}uni-muenster.de
Background The purpose was the comparison of positron emission tomography using F-18-fluorodeoxy-glucose (FDG-PET) and spiral thoracic CT to detect pulmonary metastases from malignant primary osseous tumors
Patients and methods In 71 patients with histologically confirmed malignant primary bone tumors (32 osteosarcomas, 39 Ewing's sarcomas) 111 FDG-PET examinations were evaluated with regard to pulmonary/pleural metastases in comparison with spiral thoracic CT Reference methods were the clinical follow-ups for 6–64 months (median 20 months) or a histopathologic analysis
Results In 16 patients (23%) reference methods revealed a pulmonary/pleural metastatic disease FDG-PET had a sensitivity of 0.50, a specificity of 0 98, and an accuracy of 0 87 on a patient based analysis Comparable values for spiral CT were 0 75, 1.00, and 0.94 It was shown that no patient who had a true positive FDG-PET had a false negative CT scan, nor was a pulmonary metastases detected earlier by FDG-PET than by spiral CT
Conclusions There seems to be a superiority of spiral CT in the detection of pulmonary metastases from malignant primary bone tumors as compared with FDG-PET Therefore, at present a negative FDG-PET cannot be recommended to exclude lung metastases However, as specificity of FDG-PET is high, a positive FDG-PET result can be used to confirm abnormalities seen on thoracic CT scans as metastatic
Ewing's sarcoma, FDG-PET, malignant primary bone tumors, osteosarcoma, pulmonary metastases, thoracic CT
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