FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy

Franzius, Christiane; Sciuk, J.; Daldrup-Link, Heike E.; Jürgens, Heribert; Schober, Otmar

doi:10.1007/s002590000301

Cited by 269 publications

(115 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study is intentionally limited to the assessment of the dignitiy of the primary lesion but does not assess additional information provided by the PET/CT such as grading and staging of a proven malignant tumor, or detection of multifocality, second primaries or metastases. These aspects have been investigated before in other publications (7,36,40,41). Delayed images might help in the differentiation between benign and malignant bone lesions like observed in soft tissue sarcomas (42).…”

Section: Discussionmentioning

confidence: 95%

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

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 95%

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

View full text Add to dashboard Cite

show abstract

“…The detection of viable metastases by positron emission tomography (PET) may be an approach to tackling this problem. [31][32][33][34] In summary, local therapy of the primary tumor and of viable metastases could improve the prognosis in patients with highly advanced, extrapulmonary, metastatic Ewing tumor and warrants further investigation.…”

Section: Local Therapy Disseminated Ewing Sarcoma/haeusler Et Almentioning

confidence: 99%

The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES)

Haeusler

Ranft

Boelling

et al. 2009

Cancer

147

124

View full text Add to dashboard Cite

BACKGROUND:The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES) was investigated.METHODS:We analyzed 120 patients registered into the European Ewing Tumor Working Initiative of National Groups (EURO‐E.W.I.N.G. 99) trial at the trial center of Muenster from 1998 to 2006. Median age was 16.2 years. Local treatment of the primary tumor was surgery in 26 of 120 patients, surgery and radiotherapy in 21 patients, and definitive radiotherapy in 40 patients. For treatment of metastases, 6 of 120 patients received surgery; 9 patients, surgery and radiotherapy; and 33 patients, definitive radiotherapy. Forty‐seven (39%) patients had local treatment of both the primary tumor and metastases, 41 (34%) patients of either the primary tumor or metastases, and 32 (27%) received no local therapy.RESULTS:Event‐free survival (EFS) at 3 years was 0.24 (95% CI, 0.16‐0.33). Univariate analyses demonstrated the impact of local therapy given to the primary tumor: 3‐year EFS was 0.25 with surgery, 0.47 with surgery and radiotherapy, 0.23 with radiotherapy, and 0.13 when no local therapy was administered (P < .001). Three‐year EFS in PDMES was also influenced by the local treatment: surgery, 0.33; surgery and radiotherapy, 0.56; radiotherapy, 0.35; no local therapy, 0.16 (P = .003). Three‐year EFS was 0.39 in patients who received local treatment of both primary tumor and PDMES, compared with 0.17 in patients with any local treatment of either primary tumor or PDMES and 0.14 in patients with no local therapy (P < .001). Multivariate analysis showed absence of local treatment to be the major risk factor (HR = 2.21; P = .027; n = 20).CONCLUSIONS:Local therapy of involved sites is important for patients with PDMES and should complement systemic treatment whenever possible. Cancer 2010. © 2010 American Cancer Society.

show abstract

“…Therefore, the morphologic information that is obtained by nondiagnostic (low-dose) CT performed for attenuation correction in modern hybrid PET/CT systems is of particular diagnostic value (18). 18 F-FDG PET has been shown to detect osseous Ewing tumor lesions with a high sensitivity and a high specificity (23)(24)(25). Furthermore, it has been proposed that 18 F-FDG uptake by Ewing tumors may have prognostic value and may predict a patient's clinical outcome as well as indicate the initial disease stage (26,27).…”

mentioning

confidence: 99%

Significant Benefit of Multimodal Imaging: PET/CT Compared with PET Alone in Staging and Follow-up of Patients with Ewing Tumors

Gerth

Juergens²,

Dirksen³

et al. 2007

Journal of Nuclear Medicine

130

View full text Add to dashboard Cite

Hybrid PET/CT was compared with PET alone in the staging and restaging of patients with Ewing tumor to assess the benefit of the combined imaging technique. Methods: A total of 163 18 F-FDG PET/CT studies performed in 53 patients (age: range, 4-38 y; median, 16.5 y) with histopathologically confirmed Ewing tumor were evaluated retrospectively. All PET/CT studies included low-dose CT for attenuation correction; in 91 examinations, additional diagnostic chest CT was performed. PET and CT data were assessed independently by 2 nuclear medicine physicians and 2 radiologists, respectively. Finally, both datasets were fused by use of software and analyzed by all 4 reviewers (consensus reading). Each lesion was scored with a 5-point scale. Biopsy, imaging, or clinical follow-up served as a standard of reference. Receiver operating characteristic (ROC) analyses were performed to evaluate PET and PET/CT performance characteristics. To measure the abilities to detect and correctly localize tumor foci, localization ROC (L-ROC) curves were generated for PET. Results: A total of 609 lesions were detected by PET alone. The hybrid PET/CT technique resulted in a change of score in 160 of these lesions (26%): higher scores in 23 lesions (4%) and lower scores in 137 lesions (23%). In 49 lesions detected by PET (8%), the localization had to be changed after image fusion. Additionally, 124 (21%) more lesions were found by PET/CT than by PET alone, resulting in a total of 733 lesions. As determined by lesion-based analysis, the sensitivity, specificity, and accuracy of PET were 71%, 95%, and 88%, respectively; the corresponding values for the hybrid PET/CT technique were 87%, 97%, and 94% (P , 0.0001). The areas under the curve in the ROC analysis were 0.82 for PET and 0.92 for PET/CT (P , 0.0001), and that in the L-ROC analysis was 0.66 for PET. Conclusion: PET/CT is significantly more accurate than PET alone for the detection and localization of lesions and improves staging for patients with Ewing tumor. The hybrid technique is superior to PET alone in terms of sensitivity, specificity, and accuracy, mainly because of the detection of new lesions.

show abstract

FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy

Cited by 269 publications

References 12 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

The value of local treatment in patients with primary, disseminated, multifocal Ewing sarcoma (PDMES)

Significant Benefit of Multimodal Imaging: PET/CT Compared with PET Alone in Staging and Follow-up of Patients with Ewing Tumors

Contact Info

Product

Resources

About