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18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

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Abstract

Background

F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children.

Objective

To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors.

Materials and methods

Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology.

Results

A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUVmax and greater SUVmax reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement.

Conclusion

PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy.

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Acknowledgments

Supported in part by grants from the Dutch Cancer Society (C.S.) and from Department of Oncology, The Children’s Hospital at Westmead, Sydney, Australia (K.L.).

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Authors and Affiliations

  1. Department of Nuclear Medicine, The Children’s Hospital at Westmead, Sydney, NSW, Australia

    Kevin London & Robert Howman-Giles

  2. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Kevin London

  3. Divisions of Paediatric Oncology/Haematology, VU Medical Centre, Amsterdam, The Netherlands

    Claudia Stege & Gertjan Kaspers

  4. Department of Oncology, The Children’s Hospital at Westmead, Sydney, Australia

    Siobhan Cross & Luciano Dalla-Pozza

  5. Department of Medical Imaging, The Children’s Hospital at Westmead, Sydney, Australia

    Ella Onikul

  6. Department of Pathology, The Children’s Hospital at Westmead, Sydney, Australia

    Nicole Graf

  7. Discipline of Imaging, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Robert Howman-Giles

Authors
  1. Kevin London
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  2. Claudia Stege
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  3. Siobhan Cross
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  7. Luciano Dalla-Pozza
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  8. Robert Howman-Giles
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Correspondence to Kevin London.

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London, K., Stege, C., Cross, S. et al. 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors. Pediatr Radiol 42, 418–430 (2012). https://doi.org/10.1007/s00247-011-2278-x

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  • DOI: https://doi.org/10.1007/s00247-011-2278-x

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