18F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy.
- Author:
Kenzo UCHIDA
1
;
Hideaki NAKAJIMA
;
Tsuyoshi MIYAZAKI
;
Tatsuro TSUCHIDA
;
Takayuki HIRAI
;
Daisuke SUGITA
;
Shuji WATANABE
;
Naoto TAKEURA
;
Ai YOSHIDA
;
Hidehiko OKAZAWA
;
Hisatoshi BABA
Author Information
- Publication Type:Original Article
- Keywords: 18F-fluorodeoxyglucose positron emission tomography; Technetium Tc 99m (Sn)methylenediphosphonate; Positron emission tomography and computed tomography; Spine; Metastasis
- MeSH: Biopsy; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Neoplasm Metastasis; Positron-Emission Tomography; Positron-Emission Tomography and Computed Tomography; Retrospective Studies; Spine; Technetium Tc 99m Medronate
- From:Asian Spine Journal 2013;7(2):96-103
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: A retrospective study. PURPOSE: The aims of this study were to investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions. OVERVIEW OF LITERATURE: Recent studies described limitations regarding how many lesions with abnormal 18F-FDG PET findings in the bone show corresponding morphologic abnormalities. METHODS: The subjects for this retrospective study were 227 patients with primary malignant tumors, who were suspected of having spinal metastases. They underwent combined whole-body 18F-FDG PET/CT scanning for evaluation of known neoplasms in the whole spine. 99mTc-methylene diphosphonate bone scan was performed within 2 weeks following PET/CT examinations. The final diagnosis of spinal metastasis was established by histopathological examination regarding bone biopsy or magnetic resonance imaging (MRI) findings, and follow-up MRI, CT and 18F-FDG PET for extensively wide lesions with subsequent progression. RESULTS: From a total of 504 spinal lesions in 227 patients, 224 lesions showed discordant image findings. For 122 metastatic lesions with confirmed diagnosis, the sensitivity/specificity of bone scan and FDG PET were 84%/21% and 89%/76%, respectively. In 102 true-positive metastatic lesions, the bone scan depicted predominantly osteosclerotic changes in 36% and osteolytic changes in 19%. In 109 true-positive lesions of FDG PET, osteolytic changes were depicted predominantly in 38% while osteosclerotic changes were portrayed in 15%. CONCLUSIONS: 18F-FDG PET in PET/CT could be used as a substitute for bone scan in the evaluation of spinal metastasis, especially for patients with spinal osteolytic lesions on CT.
