Skeletal Radiology

, Volume 32, Issue 4, pp 201–208 | Cite as

18FDG PET scanning of benign and malignant musculoskeletal lesions

  • Frieda FeldmanEmail author
  • Ronald van Heertum
  • Chitra Manos
Newer Technology



To describe the technique, applications and advantages of 18FDG PET scanning in detection, analysis and management of musculoskeletal lesions.

Design and patients

Forty-five patients (19 males,26 females) aged 9 to 81 years had radiographs, routine radionuclide scans, CT and/or MRI of clinically suspected active benign or malignant musculoskeletal lesions. 18FDG scans with a Siemens ECAT EXACT 921 dedicated PET unit (Knoxville, Tenn.) and FWH=6 mm images acquired as a 5–6 bed examination (6 min emission and 4 min transmission) used OSEM iterative reconstruction with segmented transmission attenuation correction and a Gaussian filter (cutoff 6.7 mm). Region of interest (ROI) 3×3 pixel image analysis based on transverse whole body images (slice thickness 3.37 mm) generated Maximum Standard Uptake Values (Max SUV) with a cutoff of 2.0 used to distinguish benign and malignant lesions.


Thirty-nine studies were available for SUV ROI analysis. Overall sensitivity for differentiating malignant from benign osseous and non-osseous lesions was 91.7% (22/24), overall specificity was 100% (11/11) with an accuracy of 91.7%. All aggressive lesions had a Max SUV >2.0. Data separating benign from malignant lesions and aggressive from benign lesions were statistically significant (P<0.001) in both categories. There was no statistically significant difference in distinguishing aggressive from malignant lesions (P, ns).


18FDG PET contributes unique information regarding metabolism of musculoskeletal lesions. By supplying a physiologic basis for more informed treatment and management, it influences prognosis and survival. Moreover, since residual, recurrent or metastatic tumors can be simultaneously documented on a single whole body scan, PET may theoretically prove to be cost-effective.


18FDG PET Musculoskeletal lesions 


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Copyright information

© ISS 2003

Authors and Affiliations

  • Frieda Feldman
    • 1
    • 2
    Email author
  • Ronald van Heertum
    • 1
    • 2
  • Chitra Manos
    • 2
  1. 1.Columbia University College of Physicians and SurgeonsNew YorkUSA
  2. 2.New York Presbyterian HospitalNew YorkUSA

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