PT  - JOURNAL ARTICLE
AU  - Schulte, Michael
AU  - Brecht-Krauss, Doris
AU  - Heymer, Berno
AU  - Guhlmann, Albrecht
AU  - Hartwig, Erich
AU  - Sarkar, Michael R.
AU  - Diederichs, Christoph G.
AU  - Baer, Alexandra Von
AU  - Kotzerke, Jörg
AU  - Reske, Sven N.
TI  - Grading of Tumors and Tumorlike Lesions of Bone: Evaluation by FDG PET
DP  - 2000 Oct 01
TA  - Journal of Nuclear Medicine
PG  - 1695--1701
VI  - 41
IP  - 10
4099  - http://jnm.snmjournals.org/content/41/10/1695.short
4100  - http://jnm.snmjournals.org/content/41/10/1695.full
SO  - J Nucl Med2000 Oct 01; 41
AB  - Clinical diagnosis of skeletal tumors can be difficult, because such lesions compose a large, heterogeneous group of entities with different biologic behaviors. The aim of this prospective study was to assess the value of PET in grading tumors and tumorlike lesions of bone. Methods: Two hundred two patients with suspected primary bone tumors were investigated using FDG PET. Uptake of FDG was evaluated semiquantitatively by determining the tumor-to-background ratio (T/B). All patients underwent biopsy, resulting in the histologic detection of 70 high-grade sarcomas, 21 low-grade sarcomas, 40 benign tumors, 47 tumorlike lesions, 6 osseous lymphomas, 6 plasmacytomas, and 12 metastases of an unknown primary tumor. Results: All lesions, with the exception of 3 benign tumors, were detected by increased FDG uptake. Although sarcomas showed significantly higher T/Bs than did latent or active benign lesions (P < 0.001), aggressive benign lesions could not be distinguished from sarcomas. Using a T/B cutoff level for malignancy of 3.0, the sensitivity of FDG PET was 93.0%, the specificity was 66.7%, and the accuracy was 81.7%. Conclusion: FDG PET provides a promising tool for estimating the biologic activity of skeletal lesions, implicating consequences for the choice of surgical strategy.