Pediatric Radiology

, Volume 42, Issue 4, pp 418–430 | Cite as

18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

  • Kevin LondonEmail author
  • Claudia Stege
  • Siobhan Cross
  • Ella Onikul
  • Nicole Graf
  • Gertjan Kaspers
  • Luciano Dalla-Pozza
  • Robert Howman-Giles
Original Article



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.


Osteosarcoma 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.).


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kevin London
    • 1
    • 2
    Email author
  • Claudia Stege
    • 3
  • Siobhan Cross
    • 4
  • Ella Onikul
    • 5
  • Nicole Graf
    • 6
  • Gertjan Kaspers
    • 3
  • Luciano Dalla-Pozza
    • 4
  • Robert Howman-Giles
    • 1
    • 7
  1. 1.Department of Nuclear MedicineThe Children’s Hospital at WestmeadSydneyAustralia
  2. 2.Discipline of Paediatrics and Child Health, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  3. 3.Divisions of Paediatric Oncology/HaematologyVU Medical CentreAmsterdamThe Netherlands
  4. 4.Department of OncologyThe Children’s Hospital at WestmeadSydneyAustralia
  5. 5.Department of Medical ImagingThe Children’s Hospital at WestmeadSydneyAustralia
  6. 6.Department of PathologyThe Children’s Hospital at WestmeadSydneyAustralia
  7. 7.Discipline of Imaging, Sydney Medical SchoolUniversity of SydneySydneyAustralia

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