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Skeletal Radiology

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01-11-2020 | Magnetic Resonance Imaging | Scientific Article

¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of spinal giant cell tumors

Authors: Le Song, Songbo Han, Weifang Zhang, Liang Jiang

Published in: Skeletal Radiology | Issue 11/2020

Abstract

Objective

To investigate the value of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in the evaluation of spinal giant cell tumors (GCTs).

Materials and methods

The PET/CT and clinical data of 16 patients with spinal GCTs were reviewed. The maximal standardized uptake value (SUVmax), longest diameter, and CT features of spinal GCTs were analyzed. The value of PET/CT and MRI in displaying the recurrent lesions was compared. PET Response Criteria in Solid Tumors were adopted to evaluate the response to radiotherapy.

Results

Data from 7 males and 9 females (median age 32.5 years) were analyzed. Eight patients had primary GCTs with a median SUVmax of 11.91 and a median length of 4.42 cm. Eight patients had relapsed GCTs with a median SUVmax of 10.34 and a median length of 6.23 cm. There was no statistical difference between the SUVmax of primary and relapsed GCTs. The SUVmax did not correlate with length. In 8 relapsed patients, 4 lesions invaded the vertebral canal, but 2 of which were not displayed on MRI. Metal prostheses showed extremely low signal intensity on MRI, even in the 3 cases with increased intra-prosthetic ¹⁸F-FDG concentration. Five relapsed patients with subsequent radiotherapy had a repeat PET/CT. A complete, partial, and stable metabolic response was observed in 1, 3, and 1 patient, respectively.

Conclusions

Both the primary and recurrent spinal GCTs avidly accumulate ¹⁸F-FDG. For recurrent GCTs, PET/CT may provide incremental value in the assessment of the vertebral canal and intra-prosthetic involvement and the response to radiotherapy.

Vangala N, Uppin SG, Ayesha SM, Harshavardhana KR, Chandrasekhar P. Metachronous multicentric giant cell tumour of bone. Skelet Radiol. 2018;47(11):1559–66. https://doi.org/10.1007/s00256-018-2954-0.CrossRef

Kwee TC, de Klerk JMH, Nix M, Heggelman BGF, Dubois SV, Adams HJA. Benign bone conditions that may be FDG-avid and mimic malignancy. Semin Nucl Med. 2017;47(4):322–51. https://doi.org/10.1053/j.semnuclmed.2017.02.004.CrossRefPubMed

Lim CH, Ahn TR, Moon SH, Cho YS, Choi JY, Kim BT, et al. PET/CT features discriminate risk of metastasis among single-bone FDG lesions detected in newly diagnosed non-small-cell lung cancer patients. Eur Radiol. 2018. https://doi.org/10.1007/s00330-018-5764-9.

Kim SJ, Lee JS. Diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography for differentiation of benign and malignant vertebral compression fractures: a meta-analysis. World Neurosurg. 2020. https://doi.org/10.1016/j.wneu.2020.02.085.

Shen Z, Xu B, Guan Z, Lei J. PET/CT in the diagnosis of giant cell tumor. J Chin Clin Med Imaging. 2017;28(6):438–41.

Muheremu A, Ma Y, Huang Z, Shan H, Li Y, Niu X. Diagnosing giant cell tumor of the bone using positron emission tomography/computed tomography: a retrospective study of 20 patients from a single center. Oncol Lett. 2017;14(2):1985–8. https://doi.org/10.3892/ol.2017.6379.CrossRefPubMedPubMedCentral

Park HL, Yoo IR, Lee Y, Park SY, Jung CK. Giant cell tumor of the rib: two cases of F-18 FDG PET/CT findings. Nucl Med Mol Imaging. 2017;51(2):182–5. https://doi.org/10.1007/s13139-016-0442-9.CrossRefPubMed

Strauss LG, Dimitrakopoulou-Strauss A, Koczan D, Bernd L, Haberkorn U, Ewerbeck V, et al. 18F-FDG kinetics and gene expression in giant cell tumors. J Nucl Med. 2004;45(9):1528–35.PubMed

Luksanapruksa P, Buchowski JM, Singhatanadgige W, Rose PC, Bumpass DB. Management of spinal giant cell tumors. Spine J. 2016;16(2):259–69. https://doi.org/10.1016/j.spinee.2015.10.045.CrossRefPubMed

10.

Raskin KA, Schwab JH, Mankin HJ, Springfield DS, Hornicek FJ. Giant cell tumor of bone. J Am Acad Orthop Surg. 2013;21(2):118–26. https://doi.org/10.5435/JAAOS-21-02-118.CrossRefPubMed

11.

Boriani S, Bandiera S, Casadei R, Boriani L, Donthineni R, Gasbarrini A, et al. Giant cell tumor of the mobile spine: a review of 49 cases. Spine (Phila Pa 1976). 2012;37(1):E37–45. https://doi.org/10.1097/BRS.0b013e3182233ccd.CrossRef

12.

Yang H, Im GH, Nielsen GP, Kheterpal A, Schwab JH. Primary thoracic giant cell tumor of bone sensitive to steroids. Skelet Radiol. 2018;47(10):1431–5. https://doi.org/10.1007/s00256-018-2911-y.CrossRef

13.

Yokogawa N, Murakami H, Demura S, Kato S, Yoshioka K, Shimizu T, et al. Total spondylectomy for Enneking stage III giant cell tumor of the mobile spine. Eur Spine J. 2018;27(12):3084–91. https://doi.org/10.1007/s00586-018-5761-3.CrossRefPubMed

14.

Manohar K, Mittal BR, Bhattacharya A, Sen R. Recurrent giant cell tumor of foot detected by F18-FDG PET/CT. Indian J Nucl Med. 2012;27(4):262–3. https://doi.org/10.4103/0972-3919.115402.CrossRefPubMedPubMedCentral

15.

McKinney AM, Reichert P, Short J, Dhurairaj T, SantaCruz K, McKinney Z, et al. Metachronous, multicentric giant cell tumor of the sphenoid bone with histologic, CT, MR imaging, and positron-emission tomography/CT correlation. AJNR Am J Neuroradiol. 2006;27(10):2199–201.PubMed

16.

Makis W, Hickeson M. Spindle cell sarcoma degeneration of giant cell tumor of the knee, imaged with F-18 FDG PET-CT and Tc-99m MDP bone scan. Clin Nucl Med. 2010;35(2):112–5. https://doi.org/10.1097/RLU.0b013e3181c7c124.CrossRefPubMed

17.

JH O, Lodge MA, Wahl RL. Practical PERCIST: a simplified guide to PET Response Criteria in Solid Tumors 1.0. Radiology. 2016;280(2):576–84. https://doi.org/10.1148/radiol.2016142043.CrossRef

18.

Subhawong TK, Winn A, Shemesh SS, Pretell-Mazzini J. F-18 FDG PET differentiation of benign from malignant chondroid neoplasms: a systematic review of the literature. Skelet Radiol. 2017;46(9):1233–9. https://doi.org/10.1007/s00256-017-2685-7.CrossRef

19.

Hoshi M, Takada J, Oebisu N, Hata K, Ieguchi M, Nakamura H. Overexpression of hexokinase-2 in giant cell tumor of bone is associated with false positive in bone tumor on FDG-PET/CT. Arch Orthop Trauma Surg. 2012;132(11):1561–8. https://doi.org/10.1007/s00402-012-1588-2.CrossRefPubMed

20.

Meena R, Aggarwal A, Bhattacharya A, Gupta V, Dhandapani S, Chhabra R. Non traumatic vertebral lesions: incremental utility of PET-CT over MRI and FNAC in a suggested diagnostic algorithm. Br J Neurosurg. 2019;33(1):25–9. https://doi.org/10.1080/02688697.2017.1301377.CrossRefPubMed

21.

Mauch JT, Carr CM, Cloft H, Diehn FE. Review of the imaging features of benign osteoporotic and malignant vertebral compression fractures. AJNR Am J Neuroradiol. 2018;39(9):1584–92. https://doi.org/10.3174/ajnr.A5528.CrossRefPubMed

22.

Salunke AA, Chen Y, Chen X, Tan JH, Singh G, Tai BC, et al. Does pathological fracture affect the rate of local recurrence in patients with a giant cell tumour of bone?: a meta-analysis. Bone Joint J. 2015;97-B(11):1566–71. https://doi.org/10.1302/0301-620x.97b11.35326.CrossRefPubMed

23.

Love C, Palestro CJ. Nuclear medicine imaging of bone infections. Clin Radiol. 2016;71(7):632–46. https://doi.org/10.1016/j.crad.2016.01.003.CrossRefPubMed

24.

Rosario M, Kim HS, Yun JY, Han I. Surveillance for lung metastasis from giant cell tumor of bone. J Surg Oncol. 2017;116(7):907–13. https://doi.org/10.1002/jso.24739.CrossRefPubMed

25.

Zhang Y, Reeve IP, Lewis DH. A case of giant cell tumor of sacrum with unusual pulmonary metastases: CT and FDG PET findings. Clin Nucl Med. 2012;37(9):920–1. https://doi.org/10.1097/RLU.0b013e31825b2441.CrossRefPubMed

26.

Makis W, Alabed YZ, Nahal A, Novales-Diaz JA, Hickeson M. Giant cell tumor pulmonary metastases mimic primary malignant pulmonary nodules on (18)F-FDG PET/CT. Nucl Med Mol Imaging. 2012;46(2):134–7. https://doi.org/10.1007/s13139-012-0134-z.CrossRefPubMedPubMedCentral

Title: 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of spinal giant cell tumors
Authors: Le Song
Songbo Han
Weifang Zhang
Liang Jiang
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Computed Tomography
Radiotherapy
Positron Emission Tomography
giant cell tumor
Published in: Skeletal Radiology / Issue 11/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-020-03468-y

At a glance: The STEP trials

Springer Medicine

¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of spinal giant cell tumors

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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