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Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma.
Pediatr Blood Cancer 2016; 63(8):1381-6PB

Abstract

BACKGROUND

Bone scintigraphy (BS) is used to detect osseous metastases in osteosarcoma. (18) F-fluorodeoxyglucose-positron emission tomography-computed tomography ((18) F-FDG-PET-CT) is being increasingly used for staging. We compared the sensitivity, specificity, and diagnostic accuracy of (18) F-FDG-PET-CT and BS for detecting osseous metastases in osteosarcoma.

METHODS

We retrospectively reviewed 39 patients with osteosarcoma who had paired PET-CT and BS at diagnosis and/or first recurrence from 2003 to 2012. Imaging studies were reviewed by two pediatric imaging specialists who were blinded to results of the opposing modality and reference standard. Reviewers categorized lesions as benign, malignant, or indeterminate. Reference standard for lesion histology was biopsy or clinical follow-up. Diagnostic performance of PET-CT, BS, and combined modalities were determined.

RESULTS

There were 40 examinations from 39 patients and 65 distant lesions were evaluated. Median age was 12 years (range 5-19 years). Four patients had 15 osseous metastases at diagnosis (two biopsied and 13 clinically), and two had five osseous metastases at recurrence (one biopsied and five clinically). For distant sites, sensitivity, specificity, and diagnostic accuracy were 79%, 89% and 86% for PET-CT, 32%, 96%, and 77% for BS, and 95%, 85%, and 88% for PET-CT/BS combined. Sensitivity of PET-CT was superior to BS (P = 0.035); combined imaging modalities were superior to BS (P < 0.001) but not better than PET-CT alone (P = 0.25). Specificity for BS approached significance compared to combined imaging (P = 0.063). Examination-based analysis yielded similar results between individual and combined imaging modalities.

CONCLUSIONS

(18) F-FDG-PET-CT demonstrated superior sensitivity over BS for detecting osseous metastases, supporting the use of (18) F-FDG-PET-CT for staging of osteosarcoma.

Authors+Show Affiliations

Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Pediatrics, M.D. Anderson Cancer Center, Houston, Texas.Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27082077

Citation

Hurley, Caitlin, et al. "Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma." Pediatric Blood & Cancer, vol. 63, no. 8, 2016, pp. 1381-6.
Hurley C, McCarville MB, Shulkin BL, et al. Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma. Pediatr Blood Cancer. 2016;63(8):1381-6.
Hurley, C., McCarville, M. B., Shulkin, B. L., Mao, S., Wu, J., Navid, F., ... Bishop, M. W. (2016). Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma. Pediatric Blood & Cancer, 63(8), pp. 1381-6. doi:10.1002/pbc.26014.
Hurley C, et al. Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma. Pediatr Blood Cancer. 2016;63(8):1381-6. PubMed PMID: 27082077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of (18) F-FDG-PET-CT and Bone Scintigraphy for Evaluation of Osseous Metastases in Newly Diagnosed and Recurrent Osteosarcoma. AU - Hurley,Caitlin, AU - McCarville,M Beth, AU - Shulkin,Barry L, AU - Mao,Shenghua, AU - Wu,Jianrong, AU - Navid,Fariba, AU - Daw,Najat C, AU - Pappo,Alberto S, AU - Bishop,Michael W, Y1 - 2016/04/15/ PY - 2015/12/23/received PY - 2016/03/17/accepted PY - 2016/4/16/entrez PY - 2016/4/16/pubmed PY - 2017/3/28/medline KW - FDG-PET KW - bone scan KW - diagnostic KW - metastatic KW - osteosarcoma SP - 1381 EP - 6 JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 63 IS - 8 N2 - BACKGROUND: Bone scintigraphy (BS) is used to detect osseous metastases in osteosarcoma. (18) F-fluorodeoxyglucose-positron emission tomography-computed tomography ((18) F-FDG-PET-CT) is being increasingly used for staging. We compared the sensitivity, specificity, and diagnostic accuracy of (18) F-FDG-PET-CT and BS for detecting osseous metastases in osteosarcoma. METHODS: We retrospectively reviewed 39 patients with osteosarcoma who had paired PET-CT and BS at diagnosis and/or first recurrence from 2003 to 2012. Imaging studies were reviewed by two pediatric imaging specialists who were blinded to results of the opposing modality and reference standard. Reviewers categorized lesions as benign, malignant, or indeterminate. Reference standard for lesion histology was biopsy or clinical follow-up. Diagnostic performance of PET-CT, BS, and combined modalities were determined. RESULTS: There were 40 examinations from 39 patients and 65 distant lesions were evaluated. Median age was 12 years (range 5-19 years). Four patients had 15 osseous metastases at diagnosis (two biopsied and 13 clinically), and two had five osseous metastases at recurrence (one biopsied and five clinically). For distant sites, sensitivity, specificity, and diagnostic accuracy were 79%, 89% and 86% for PET-CT, 32%, 96%, and 77% for BS, and 95%, 85%, and 88% for PET-CT/BS combined. Sensitivity of PET-CT was superior to BS (P = 0.035); combined imaging modalities were superior to BS (P < 0.001) but not better than PET-CT alone (P = 0.25). Specificity for BS approached significance compared to combined imaging (P = 0.063). Examination-based analysis yielded similar results between individual and combined imaging modalities. CONCLUSIONS: (18) F-FDG-PET-CT demonstrated superior sensitivity over BS for detecting osseous metastases, supporting the use of (18) F-FDG-PET-CT for staging of osteosarcoma. SN - 1545-5017 UR - https://www.unboundmedicine.com/medline/citation/27082077/Comparison_of__18__F_FDG_PET_CT_and_Bone_Scintigraphy_for_Evaluation_of_Osseous_Metastases_in_Newly_Diagnosed_and_Recurrent_Osteosarcoma_ L2 - https://doi.org/10.1002/pbc.26014 DB - PRIME DP - Unbound Medicine ER -