Differentiation between malignant and benign pathologic fractures with F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography

Shin, Dong-Gu; Shon, Oog-Jin; Byun, Seongmin; Choi, Jun-Hyuk; Chun, KyunghAh; Cho, I.-H.

doi:10.1007/s00256-008-0462-3

Cited by 54 publications

(31 citation statements)

References 16 publications

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“…and based on medullary uptake, which is characteristic for malignant fractures (29,30). Fractures in two of our patients were caused by benign lesions, one was PET positive (SUV max.…”

Section: Discussionmentioning

confidence: 99%

The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

Strobel

Exner

Stumpe

et al. 2008

Eur J Nucl Med Mol Imaging

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OBJECTIVE: To evaluate the value of a dedicated interpretation of the CT images in the differential diagnosis of benign vs. malignant primary bone lesions with 18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT). MATERIALS AND METHODS: In 50 consecutive patients (21 women, 29 men, mean age 36.9, age range 11-72) with suspected primary bone neoplasm conventional radiographs and 18F-FDG-PET/CT were performed. Differentiation of benign and malignant lesions was separately performed on conventional radiographs, PET alone (PET), and PET/CT with specific evaluation of the CT part. Histology served as the standard of reference in 46 cases, clinical, and imaging follow-up in four cases. RESULTS: According to the standard of reference, conventional 17 lesions were benign and 33 malignant. Sensitivity, specificity, and accuracy in assessment of malignancy was 85%, 65% and 78% for conventional radiographs, 85%, 35% and 68% for PET alone and 91%, 77% and 86% for combined PET/CT. Median SUV(max) was 3.5 for benign lesions (range 1.6-8.0) and 5.7 (range 0.8-41.7) for malignant lesions. In eight patients with bone lesions with high FDG-uptake (SUV(max) >or= 2.5) dedicated CT interpretation led to the correct diagnosis of a benign lesion (three fibrous dysplasias, two osteomyelitis, one aneurysmatic bone cyst, one fibrous cortical defect, 1 phosphaturic mesenchymal tumor). In four patients with lesions with low FDG-uptake (SUV(max) < 2.5) dedicated CT interpretation led to the correct diagnosis of a malignant lesion (three chondrosarcomas and one leiomyosarcoma). Combined PET/CT was significantly more accurate in the differentiation of benign and malignant lesions than PET alone (p = .039). There was no significant difference between PET/CT and conventional radiographs (p = .625). CONCLUSION: Dedicated interpretation of the CT part significantly improved the performance of FDG-PET/CT in differentiation of benign and malignant primary bone lesions compared to PET alone. PET/CT more commonly differentiated benign from malignant primary bone lesions compared with conventional radiographs, but this difference was not significant. The Additional Value of CT Images Interpretation in the Differential Diagnosis of Benign vs. Malignant Primary Bone Lesions with 18F- FDG-PET/CT Abstract ObjectiveTo evaluate the value of a dedicated interpretation of the CT images in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT. MethodsIn 50 consecutive patients (21 female, 29 male, mean age 36.9, age range 11 -72) with suspected primary bone neoplasm conventional radiographs and 18F-FDG-PET/CT were performed. Differentiation of benign and malignant lesions was separately performed on conventional radiographs, PET alone (PET) and PET/CT with specific evaluation of the CT part. Histology served as the standard of reference in 46 cases, clinical and imaging follow-up in four cases. ResultsAccording to the standard of reference conventional 17 lesions were benign and...

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“…and based on medullary uptake, which is characteristic for malignant fractures (29,30). Fractures in two of our patients were caused by benign lesions, one was PET positive (SUV max.…”

Section: Discussionmentioning

confidence: 99%

The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

Strobel

Exner

Stumpe

et al. 2008

Eur J Nucl Med Mol Imaging

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“…FDG-PET/CT may have an adjunctive role in differentiating benign and malignant VCFs by providing metabolic information. [57][58][59][60] It has been shown that there is overlap in the appearance of benign and malignant bone lesions on this technique, but to date, published data are not extensive. 57,58 Generally, fractures due to tumors are expected to accumulate FDG, while benign fractures are not expected to accumulate FDG to a similarly high degree.…”

Section: Fdg-pet/ctmentioning

confidence: 99%

Review of the Imaging Features of Benign Osteoporotic and Malignant Vertebral Compression Fractures

Mauch

Carr

Cloft

et al. 2018

AJNR Am J Neuroradiol

115

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SUMMARY: Vertebral compression fractures are very common, especially in the elderly. Benign osteoporotic and malignant vertebral compression fractures have extremely different management and prognostic implications. Although there is an overlap in appearances, characteristic imaging features can aid in the distinction between these 2 types of compression fractures. The aim of this review is to characterize the imaging features of benign and malignant vertebral compression fractures seen with CT, PET, SPECT, and MR imaging.ABBREVIATIONS: SI ϭ signal intensity; SUV ϭ standard uptake value; VCF ϭ vertebral compression fracture

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“…Radiography, CT, MRI and bone scintigraphy may be nonspecific. Some reports suggest that 18F-FDG-PET may be useful in differentiating between malignant and benign fractures (88)(89)(90)(91), although there are only a few case reports regarding the clinical efficacy of fusion PET/CT on differentiating malignant from benign fractures (92)(93). Overlap of benign and malignant lesions has been shown (94).…”

Section: Differential Diagnosis Of Spinal Tumor By Petmentioning

confidence: 99%

Current Molecular Imaging of Spinal Tumors in Clinical Practice

Sandu

Pöpperl²,

Toubert

et al. 2011

Mol Med

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Energy metabolism measurements in spinal cord tumors, as well as in osseous spinal tumors/metastasis in vivo, are rarely performed only with molecular imaging (MI) by positron emission tomography (PET). This imaging modality developed from a small number of basic clinical science investigations followed by subsequent work that influenced and enhanced the research of others. Apart from precise anatomical localization by coregistration of morphological imaging and quantification, the most intriguing advantage of this imaging is the opportunity to investigate the time course (dynamics) of disease-specific molecular events in the intact organism. Most importantly, MI represents one of the key technologies in translational molecular neuroscience research, helping to develop experimental protocols that may later be applied to human patients. PET may help monitor a patient at the vertebral level after surgery and during adjuvant treatment for recurrent or progressive disease. Common clinical indications for MI of primary or secondary CNS spinal tumors are: (i) tumor diagnosis, (ii) identification of the metabolically active tumor compartments (differentiation of viable tumor tissue from necrosis) and (iii) prediction of treatment response by measurement of tumor perfusion or ischemia. While spinal PET has been used under specific circumstances, a question remains as to whether the magnitude of biochemical alterations observed by MI in CNS tumors in general (specifically spinal tumors) can reveal any prognostic value with respect to survival. MI may be able to better identify early disease and to differentiate benign from malignant lesions than more traditional methods. Moreover, an adequate identification of treatment effectiveness may influence patient management. MI probes could be developed to image the function of targets without disturbing them or as treatment to modify the target's function. MI therefore closes the gap between in vitro and in vivo integrative biology of disease. At the spinal level, MI may help to detect progression or recurrence of metastatic disease after surgical treatment. In cases of nonsurgical treatments such as chemo-, hormone-or radiotherapy, it may better assess biological efficiency than conventional imaging modalities coupled with blood tumor markers. In fact, PET provides a unique possibility to correlate topography and specific metabolic activity, but it requires additional clinical and experimental experience and research to find new indications for primary or secondary spinal tumors.

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Differentiation between malignant and benign pathologic fractures with F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography

Cited by 54 publications

References 16 publications

The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

Review of the Imaging Features of Benign Osteoporotic and Malignant Vertebral Compression Fractures

Current Molecular Imaging of Spinal Tumors in Clinical Practice

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