Is methylene diphosphonate bone scan necessary for initial staging of Ewing sarcoma if18F-FDG PET/CT is performed? Journal Article


Authors: Ulaner, G. A.; Magnan, H.; Healey, J. H.; Weber, W. A.; Meyers, P. A.
Article Title: Is methylene diphosphonate bone scan necessary for initial staging of Ewing sarcoma if18F-FDG PET/CT is performed?
Abstract: OBJECTIVE. The purpose of this study was to determine whether methylene diphosphonate (MDP) bone scans are necessary during initial staging in patients with Ewing sarcoma (ES) in whom 18F-FDG PET/CT is performed. MATERIALS AND METHODS. A retrospective review was performed of patients who underwent FDG PET/CT and MDP bone scan before treatment of newly diagnosed ES from January 2004 to November 2012. Studies were reviewed to document suspected primary and metastatic malignancy. Pathology and imaging follow-up were used to determine the presence or absence of disease at suspected sites. RESULTS. Sixty patients were identified in whom FDG PET/CT and MDP bone scans were performed before treatment of newly diagnosed ES. Forty-four primary malignancies had a lytic CT appearance, three were sclerotic, and 13 involved only soft tissue. In 11 of 12 patients with osseous metastases, these were detected on PET/CT, with the one false-negative occurring in a sclerotic primary tumor; in nine of 12 patients with osseous metastases, these were detected on MDP bone scan, with the three false-negatives occurring in patients with lytic primary tumors. Only one of 13 patients with a soft-tissue primary malignancy had bone metastases on both bone scan and PET/CT. PET/CT also showed that eight patients had lung metastases and three patients had lymph node metastases, which were not evident on MDP bone scan. CONCLUSION. When ES is lytic, MDP bone scan does not add to staging performed by FDG PET/CT; thus, MDP bone scanning may be omitted. However, when ES is sclerotic, MDP bone scan may detect osseous metastases not detected by FDG PET/CT. © American Roentgen Ray Society.
Keywords: adult; child; controlled study; preschool child; primary tumor; major clinical study; bone metastasis; cancer staging; follow up; lymph node metastasis; staging; image analysis; retrospective study; ewing sarcoma; false negative result; lung metastasis; diagnostic value; vein thrombosis; fluorodeoxyglucose f 18; medronate technetium tc 99m; computer assisted emission tomography; metastases; fdg pet/ct; soft tissue tumor; bone scintiscanning; human; priority journal; article; mdp bone scan
Journal Title: American Journal of Roentgenology
Volume: 202
Issue: 4
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2014-04-01
Start Page: 859
End Page: 867
Language: English
DOI: 10.2214/ajr.13.11239
PROVIDER: scopus
PUBMED: 24660717
DOI/URL:
Notes: Export Date: 1 May 2014 -- CODEN: AJROA -- Source: Scopus
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MSK Authors
  1. Gary Ulaner
    147 Ulaner
  2. Paul Meyers
    311 Meyers
  3. John H Healey
    550 Healey
  4. Heather Magnan
    31 Magnan
  5. Wolfgang Andreas Weber
    173 Weber