The value of thallium and three-phase bone scans in the evaluation of bone and soft tissue sarcomas Journal Article


Authors: Caluser, C. I.; Abdel-Dayem, H. M.; Macapinlac, H. A.; Scott, A.; Healey, J. H.; Huvos, A.; Kalaigian, H.; Yeh, S. D. J.; Larson, S. M.
Article Title: The value of thallium and three-phase bone scans in the evaluation of bone and soft tissue sarcomas
Abstract: Thirty-seven patients with newly diagnosed or treated sarcomas had 47 sets of sequential thallium scans (TS) followed by three-phase bone scan (TPBS) on the same day. The diagnosis in all patients was verified by biopsy (n=40) or long-term follow-up studies (n=7). The sensitivity, specificity, and accuracy of TS and TPBS in detecting sarcomatous lesions was calculated: TS sensitivity was 88%, specificity 69%, and accuracy 83%; blood flow (BF) and blood pool (BP) sensitivity was 91%, specificity 54%, and accuracy 81 %; delayed bone scan (DB) sensitivity was 88%, specificity 38%, and accuracy 74%. In 17 studies the flow and blood pool parts of the TPBS and TS demonstrated the soft tissue component of sarcomas, which would have been missed if only the delayed bone scan had been performed. The TS lesion to normal tissue ratio alone was not very helpful in differentiating sarcomas from benign conditions because some benign lesions are highly cellular and vascular while some malignant lesions, such as chondrosarcoma, have poor vascularity and a less cellular chondroid matrix. However, when the thallium ratio was correlated with similar ratios calculated from yhe BP image, it was found that if the TS lesion to normal tissue ratio exceeded the BP lesion to normal tissue ratio (12 patients), the specificity for detecting sarcomatous lesions was 100%. Nevertheless, the reverse was not true. The positive predictive value of this observation was 100% and the negative predictive value was 37%. © 1994 Springer-Verlag.
Keywords: osteosarcoma; adolescent; adult; child; clinical article; school child; aged; bone neoplasms; clinical trial; comparative study; follow up; diagnostic accuracy; sensitivity and specificity; differential diagnosis; tumor biopsy; vascularization; sarcoma; blood; diagnostic value; predictive value of tests; soft tissue sarcoma; bone and bones; benign tumor; evaluation studies; blood flow; chondrosarcoma; soft tissue neoplasms; bone scintiscanning; thallium radioisotopes; middle age; technetium tc 99m medronate; bone scan; thallium chloride tl 201; human; male; female; article; thallium-201 chloride
Journal Title: European Journal of Nuclear Medicine
Volume: 21
Issue: 11
ISSN: 0340-6997
Publisher: Springer Verlag  
Date Published: 1994-11-01
Start Page: 1198
End Page: 1205
Language: English
DOI: 10.1007/bf00182353
PROVIDER: scopus
PUBMED: 7859771
DOI/URL:
Notes: Export Date: 14 January 2019 -- Article -- Source: Scopus
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MSK Authors
  1. Samuel D J Yeh
    107 Yeh
  2. Steven M Larson
    958 Larson
  3. John H Healey
    547 Healey
  4. Andrew G Huvos
    289 Huvos
  5. Andrew M. Scott
    62 Scott