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Annals of Oncology 13:157-160, 2002
© 2002 European Society for Medical Oncology

FDG–PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging

C. Franzius1,+, H. E. Daldrup-Link2,§, A. Wagner-Bohn3, J. Sciuk1, W. L. Heindel2, H. Jürgens3 and O. Schober1

Departments of 1Nuclear Medicine, 2Clinical Radiology and 3Pediatric Hematology and Oncology, University Hospital, Münster, Germany

Received 27 April 2001; revised 28 June 2001; accepted 27 July 2001.

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.

Key words: bone scintigraphy, CT, FDG–PET, malignant primary bone tumors, MRI, recurrences


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