18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors
- 427 Downloads
F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children.
To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors.
Materials and methods
Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology.
A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUVmax and greater SUVmax reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement.
PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy.
KeywordsOsteosarcoma Ewing sarcoma Bone neoplasm FDG Positron emission tomography
Supported in part by grants from the Dutch Cancer Society (C.S.) and from Department of Oncology, The Children’s Hospital at Westmead, Sydney, Australia (K.L.).
- 1.Howman-Giles R, Hicks RJ, McCowage G et al (2006) Primary bone tumors. In: Charron M (ed) Practical pediatric PET imaging. Springer, New YorkGoogle Scholar
- 12.Lowrey R Clinical calculator 1. http://faculty.vassar.edu/lowry/clin1.html. Accessed November 2010
- 16.Peat J, Barton B (2005) In: Medical statistics: a guide to data analysis and critical appraisal, 1st edn. Blackwell, Malden, MA, pp 285–286Google Scholar
- 22.Benz MR, Evilevitch V, Allen-Auerbach MS et al (2008) Treatment monitoring by 18F-FDG PET/CT in patients with sarcomas: interobserver variability of quantitative parameters in treatment-induced changes in histopathologically responding and nonresponding tumors. J Nucl Med 49:1038–1046. doi: 10.2967/jnumed.107.050187 PubMedCrossRefGoogle Scholar