FDG–PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging

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Abstract
Background The aim of this study was to assess the diagnostic ability of positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG–PET) in the detection of recurrences from malignant primary bone tumors compared with conventional imaging. Patients and methods In 27 patients (6 osteosarcomas, 21 Ewing’s sarcomas), 41 FDG–PET examinations performed for diagnosis or exclusion of recurrent disease were evaluated. Conventional imaging techniques consisted of magnetic resonance imaging of the primary tumor site, thoracic computed tomography, and Tc-99m methylene diphosphonate bone scintigraphy. The reference methods were the histopathological analysis and/or the clinical and imaging follow-up. Results In 25 examinations reference methods revealed 52 sites of recurrent disease (local n = 7; distant: osseous n = 22, pulmonary n = 13, soft tissue n = 10). On an examination-based analysisFDG–PET had a sensitivity of 0.96, a specificity of 0.81 and an accuracy of 0.90. Corresponding values for conventional imaging were 1.0, 0.56 and 0.82. Conclusions The sensitivity, specificity and accuracy of FDG–PET in the detection of recurrences from osseous sarcomas are high. On an examination-based analysis, FDG–PET had a not significantly lower sensitivity in comparison with conventional imaging. However, FDG–PET showed a small advantage in the detection of osseous and soft-tissue recurrences compared with conventional imaging.