Pediatric bone sarcoma: Diagnostic performance of (18)F-FDG PET/CT versus conventional imaging for initial staging and follow-up Journal Article

Authors: Quartuccio, N.; Fox, J.; Kuk, D.; Wexler, L. H.; Baldari, S.; Cistaro, A.; Schoder, H.
Article Title: Pediatric bone sarcoma: Diagnostic performance of (18)F-FDG PET/CT versus conventional imaging for initial staging and follow-up
Abstract: OBJECTIVE. The purpose of this study was to compare the diagnostic performance of F-18-FDG PET/CT and conventional imaging for staging and follow-up of pediatric osteosarcoma and skeletal Ewing sarcoma. MATERIALS AND METHODS. We calculated sensitivity, specificity, and accuracy of PET/CT and conventional imaging (CT, MRI, bone scanning) for sites of disease and number of lesions. Diagnostic benefit, defined as better characterization of lesions, was evaluated on a per-scan basis, comparing PET/CT and conventional imaging. RESULTS. A total of 412 lesions were characterized by imaging in 64 patients (20, osteosarcoma; 44, Ewing sarcoma). For osteosarcoma patients PET/CT was available only at follow-up, where it proved more accurate than conventional imaging for the detection of bone lesions (accuracy, 95% vs 67% for CT and 86% for MRI) and complementary to CT in evaluating lung nodules (sensitivity, 84% vs 94%; specificity, 79% vs 71%) with diagnostic benefit in 18% of examinations. In patients with Ewing sarcoma, PET/CT tended to perform better during follow-up than at initial staging (accuracy, 85% vs 69%). For lung findings, PET/CT was more specific than CT but was less sensitive. The diagnostic benefit of PET/CT was greater at staging (28%) than during followup (9%). On a per-patient basis, PET/CT provided diagnostic benefit in 21 of 44 patients with Ewing sarcoma and nine of 20 patients with osteosarcoma at least once during clinical management. CONCLUSION. FDG PET/CT provides diagnostic benefit in Ewing sarcoma and osteosarcoma, with the exception of small lung nodules. Prospective studies are needed to define the best imaging algorithm and combination of tests in the staging and follow-up of patients with pediatric bone sarcoma.
Keywords: osteosarcoma; accuracy; ewing sarcoma; tumors; metastases; management; family; fdg; f-18-fdg pet/ct; body-weight; emission tomography/computed tomography; prognosis; pediatric bone sarcoma
Journal Title: American Journal of Roentgenology
Volume: 204
Issue: 1
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2015-01-01
Start Page: 153
End Page: 160
Language: English
ACCESSION: WOS:000348562300046
DOI: 10.2214/ajr.14.12932
PUBMED: 25539251
Notes: Article -- Source: Wos
Citation Impact
MSK Authors
  1. Josef J Fox
    54 Fox
  2. Leonard H Wexler
    150 Wexler
  3. Heiko Schoder
    334 Schoder
  4. Deborah Kuk
    86 Kuk