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01-12-2013 | Scientific Article

Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma

Authors: Byung Hyun Byun, Chang-Bae Kong, Ilhan Lim, Byung Il Kim, Chang Woon Choi, Won Seok Song, Wan Hyeong Cho, Dae-Geun Jeon, Jae-Soo Koh, Soo-Yong Lee, Sang Moo Lim

Published in: Skeletal Radiology | Issue 12/2013

Abstract

Objective

We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma.

Materials and methods

We retrospectively reviewed 206 patients with stage II–IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated.

Results

Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98 %, respectively, for PET/CT; 76, 97, and 96 %, respectively, for BS; and 100, 96, and 97 %, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100 %) was significantly higher than that of PET/CT (92 %) or BS (74 %) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77 %).

Conclusions

PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity.

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Bacci G, Longhi A, Bertoni F, et al. Bone metastases in osteosarcoma patients treated with neoadjuvant or adjuvant chemotherapy: the Rizzoli experience in 52 patients. Acta Orthop. 2006;77:938–43.PubMedCrossRef

Huth JF, Eilber FR. Patterns of recurrence after resection of osteosarcoma of the extremity. Strategies for treatment of metastases. Arch Surg. 1989;124:122–6.PubMedCrossRef

Aung L, Gorlick R, Healey JH, et al. Metachronous skeletal osteosarcoma in patients treated with adjuvant and neoadjuvant chemotherapy for nonmetastatic osteosarcoma. J Clin Oncol. 2003;21:342–8.PubMedCrossRef

San-Julian M, Diaz-de-Rada P, Noain E, Sierrasesumaga L. Bone metastases from osteosarcoma. Int Orthop. 2003;27:117–20.PubMed

Meyer JS, Nadel HR, Marina N, et al. Imaging guidelines for children with Ewing sarcoma and osteosarcoma: a report from the Children’s Oncology Group Bone Tumor Committee. Pediatr Blood Cancer. 2008;51:163–70.PubMedCrossRef

Franzius C, Sciuk J, Daldrup-Link HE, Jürgens H, Schober O. FDG-PET for detection of osseous metastases from malignant primary bone tumours: comparison with bone scintigraphy. Eur J Nucl Med. 2000;27:1305–11.PubMedCrossRef

Cheon GJ, Kim MS, Lee JA, et al. Prediction model of chemotherapy response in osteosarcoma by 18F-FDG PET and MRI. J Nucl Med. 2009;50:1435–40.PubMedCrossRef

Im HJ, Kim TS, Park SY, et al. Prediction of tumour necrosis fractions using metabolic and volumetric 18F-FDG PET/CT indices, after one course and at the completion of neoadjuvant chemotherapy, in children and young adults with osteosarcoma. Eur J Nucl Med Mol Imaging. 2012;39:39–49.PubMedCrossRef

Reddick RL, Michelitch HJ, Levine AM, Triche TJ. Osteogenic sarcoma: a study of the ultrastructure. Cancer. 1980;45:64–71.PubMedCrossRef

10.

Volker T, Denecke T, Steffen I, et al. Positron emission tomography for staging of pediatric sarcoma patients: results of a prospective multicenter trial. J Clin Oncol. 2007;25:5435–41.PubMedCrossRef

11.

Walter F, Czernin J, Hall T, et al. Is there a need for dedicated bone imaging in addition to 18F-FDG PET/CT imaging in pediatric sarcoma patients? J Pediatr Hematol Oncol. 2012;34:131–6.PubMedCrossRef

12.

Hutchings M, Barrington SF. PET/CT for therapy response assessment in lymphoma. J Nucl Med. 2009;50 suppl 1:S21–30.CrossRef

13.

Kong CB, Song WS, Cho WH, Oh JM, Jeon DG. Local recurrence has only a small effect on survival in high-risk extremity osteosarcoma. Clin Orthop Relat Res. 2012;470:1482–90.PubMedCrossRef

14.

Ozulker T, Kucukoz Uzun A, Ozulker F, Ozpaçac T. Comparison of (18)F-FDG-PET/CT with (99m)Tc-MDP bone scintigraphy for the detection of bone metastases in cancer patients. Nucl Med Commun. 2010;31:597–603.PubMed

15.

Yang KT, Yang AD. Evaluation of activity of epiphyseal plates in growing males and females. Calcif Tissue Int. 2006;78:348–56.PubMedCrossRef

16.

Harcke HT, Mandell GA. Scintigraphic evaluation of the growth plate. Semin Nucl Med. 1993;23:266–73.PubMedCrossRef

17.

Guillemart A, Le Pape A, Galy G, Besnard JC. Bone kinetics of calcium-45 and pyrophosphate labeled with technetium-96: an autoradiographic evaluation. J Nucl Med. 1980;21:466–70.PubMed

18.

Helyar V, Mohan HK, Barwick T, Besnard JC. The added value of multislice SPECT/CT in patients with equivocal bony metastasis from carcinoma of the prostate. Eur J Nucl Med Mol Imaging. 2010;37:706–13.PubMedCrossRef

19.

Oh JR, Byun BH, Hong SP, et al. Comparison of ¹³¹I whole-body imaging, ¹³¹I SPECT/CT, and ¹⁸F-FDG PET/CT in the detection of metastatic thyroid cancer. Eur J Nucl Med Mol Imaging. 2011;38:1459–68.PubMedCrossRef

20.

Nakai T, Okuyama C, Kubota T, et al. Pitfalls of FDG-PET for the diagnosis of osteoblastic bone metastases in patients with breast cancer. Eur J Nucl Med Mol Imaging. 2005;32:1253–8.PubMedCrossRef

21.

Abe K, Sasaki M, Kuwabara Y, et al. Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med. 2005;19:573–9.PubMedCrossRef

22.

Zaidi H, Ojha N, Morich M, et al. Design and performance evaluation of a whole-body Ingenuity TF PET-MRI system. Phys Med Biol. 2011;56:3091–106.PubMedCrossRef

23.

Pfluger T, Melzer HI, Mueller WP, et al. Diagnostic value of combined ¹⁸F-FDG PET/MRI for staging and restaging in paediatric oncology. Eur J Nucl Med Mol Imaging. 2012;39:1745–55.PubMedCrossRef

Title: Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma
Authors: Byung Hyun Byun
Chang-Bae Kong
Ilhan Lim
Byung Il Kim
Chang Woon Choi
Won Seok Song
Wan Hyeong Cho
Dae-Geun Jeon
Jae-Soo Koh
Soo-Yong Lee
Sang Moo Lim
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Skeletal Radiology / Issue 12/2013
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-013-1714-4

At a glance: The STEP trials

Springer Medicine

Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma

Abstract

Objective

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

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