RT Journal Article
SR Electronic
T1 Grading of Tumors and Tumorlike Lesions of Bone: Evaluation by FDG PET
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1695
OP 1701
VO 41
IS 10
A1 Michael Schulte
A1 Doris Brecht-Krauss
A1 Berno Heymer
A1 Albrecht Guhlmann
A1 Erich Hartwig
A1 Michael R. Sarkar
A1 Christoph G. Diederichs
A1 Alexandra Von Baer
A1 Jörg Kotzerke
A1 Sven N. Reske
YR 2000
UL http://jnm.snmjournals.org/content/41/10/1695.abstract
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.