F-18 FDG-PET for Detection of Osseous Metastatic Disease and Staging, Restaging, and Monitoring Response to Therapy of Musculoskeletal Tumors

ABSTRACT

Recent advances in PET technology and applications have led to a proliferation in PET and PET/CT imaging, allowing correlation of both physiologic and anatomic information. This has also led to new and innovative ways to utilize PET imaging for the evaluation of musculoskeletal neoplasm. Currently, the most widely utilized musculoskeletal application of F-18 FDG-PET imaging is for the detection and characterization of osseous metastatic disease. The other notable potential role for FDG-PET imaging is for staging and restaging of primary bone tumors and soft tissue sarcomas. Precise staging and restaging of musculoskeletal neoplasm is critical to optimize treatment planning and to accurately determine patient prognosis. FDG-PET is also useful in evaluating response to therapy for musculoskeletal tumors. The future likely holds even more unique and potentially quite useful applications of PET imaging for primary osseous and soft tumors. This article will review the common and potentially useful applications of F-18 FDG-PET imaging for evaluating musculoskeletal tumors and malignancy.

KEYWORDS

FDG-PET - musculoskeletal - sarcoma - metastases - staging - restaging

REFERENCES

• 1 El-Zeftawy H, Heiba S I, Jana S et al.. Role of repeated F-18 fluorodeoxyglucose imaging in management of patients with bone and soft tissue sarcoma.  Cancer Biother Radiopharm. 2001;  16 37-46
• 2 Suzuki H, Watanabe H, Shinozaki T, Yanagawa T, Suzuki R, Takagishi K. Positron emission tomography imaging of musculoskeletal tumors in the shoulder girdle.  J Shoulder Elbow Surg. 2004;  13(6) 635-647
• 3 Peterson J J, Kransdorf M J, O'Connor M I. Diagnosis of occult bone metastases: positron emission tomography.  Clin Orthop Relat Res. 2003;  (415S) S120-S128
• 4 Daldrup-Link H E, Franzius C, Link T M et al.. Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET.  AJR Am J Roentgenol. 2001;  177 229-236
• 5 Bastiaannet E, Groen H, Jager P L et al.. The value of FDG-PET in the detection, grading, and response to therapy of soft tissue and bone sarcomas; a systematic review and meta-analysis.  Cancer Treat Rev. 2004;  30 83-101
• 6 Bredella M A, Caputo G R, Steinbach L S. Value of FDG positron emission tomography in conjunction with MR imaging for evaluating therapy response in patients with musculoskeletal sarcomas.  AJR Am J Roentgenol. 2002;  179(5) 1145-1150
• 7 Hawkins D S, Rajendran J G, Conrad III E U, Bruckner J D, Eary J F. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-D-glucose positron emission tomography.  Cancer. 2002;  94(12) 3277-3284
• 8 Bushberg J T, Seibert J A, Leidholdt E M, Boone J M. Nuclear imaging-emission tomography. In: Bushberg JT The Essential Physics of Medical Imaging. Philadelphia; Lippincott Williams & Wilkins 2002: 719-735
• 9 Kostakoglu L, Agress H, Goldsmith S J. Clinical role of FDG PET in evaluation of cancer patients.  Radiographics. 2003;  23 315-340
• 10 Shreve P D, Grossman H B, Gross M D, Wahl R L. Metastatic prostate cancer: initial findings of PET with 2-deoxy-2-[F18]fluoro-D-glucose.  Radiology. 1996;  199 751-756
• 11 Ilaslan H, Sundaram M. Advances in musculoskeletal tumor imaging.  Orthop Clin North Am. 2006;  37 375-391
• 12 Aoki J, Watanabe H, Shinozaki T et al.. FDG PET of primary benign and malignant bone tumors: standardized uptake value in 52 lesions.  Radiology. 2001;  219 774-777
• 13 Goodin G S, Shulkin B L, Kaufman R A, McCarville M B. PET/CT characterization of fibroosseous defects in children:18F-FDG uptake can mimic metastatic disease.  AJR Am J Roentgenol. 2006;  187 1124-1128
• 14 Ho Y Y. Review of non-positron emission tomography functional imaging or primary musculoskeletal tumours: beyond the humble bone scan.  Australas Radiol. 2005;  49 445-459
• 15 McCarville M B, Christie R, Daw N C, Spunt S L, Kaste S C. PET/CT in the evaluation of childhood sarcomas.  AJR Am J Roentgenol. 2005;  184 1293-1304
• 16 Franzius C, Bielack S, Flege S, Sciuk J, Jurgens H, Schober O. Prognostic significance of 18F-FDG and 99mTc-methylene diphosphonate uptake in primary osteosarcoma.  J Nucl Med. 2002;  43(8) 1012-1017
• 17 Franzius C, Daldrup-Link H E, Wagner-Bohn A et al.. FDG-PET for detection of recurrences from malignant primary bone tumors: comparison with conventional imaging.  Ann Oncol. 2002;  13 157-160
• 18 Hawkins D S, Rajendran J G, Conrad III E U, Bruckner J D, Eary J F. Evaluation of chemotherapy response in pediatric bone sarcoma by [f-18]-fluorodeoxy-D-glucose positron emission tomography.  Cancer. 2002;  94(12) 3277-3284
• 19 Malhotra P, Berman C G. Evaluation of bone metastases in lung cancer.  Cancer Control. 2002;  9(3) 254-260
• 20 Yang S N, Liang J A, Lin F J, Kao C H, Lin C C, Lee C C. Comparing whole body 18F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphonate bone scan to detect bone metastases in patients with breast cancer.  J Cancer Res Clin Oncol. 2002;  128 325-328
• 21 Cook G J, Houston S, Rubens R, Maisey M N, Fogelman I. Detection of bone metastases in breast cancer by (18)FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions.  J Clin Oncol. 1998;  16 3375-3379
• 22 Fogelman I, Cook G, Israel O, Van der Wall H. Positron emission tomography and bone metastases.  Semin Nucl Med. 2005;  35(2) 135-142
• 23 Bury T, Barreto A, Daenen F, Barthelemy N, Ghaye B, Rigo P. Fluorine-18 deoxyglucose positron emission tomography for the detection of bone metastases in patients with non-small cell lung cancer.  Eur J Nucl Med. 1998;  25 1244-1247
• 24 Moog F, Kotzerke J, Reske S N. FDG PET can replace bone scintigraphy in primary staging of malignant lymphoma.  J Nucl Med. 1999;  40(9) 1407-1413
• 25 Pieterman R M, Van Putten J W, Meuzelaar J J et al.. Preoperative staging of non-small cell lung cancer with positron emission tomography.  N Engl J Med. 2000;  343 254-261
• 26 Valk P E, Pounds T R, Hopkins D M et al.. Staging non-small cell lung cancer by whole-body positron emission tomographic imaging.  Ann Thorac Surg. 1995;  60 1573-1581
• 27 Schirrmeister H, Bommer M, Buck A K et al.. Initial results in the assessment of multiple myeloma using 18F-FDG PET.  Eur J Nucl Med Mol Imaging. 2002;  29 361-366
• 28 Rybak L D, Rosenthal D I. Radiological imaging for the diagnosis of bone metastases.  Q J Nucl Med. 2001;  45 53-64
• 29 Daldrup-Link H E, Franzius C, Link T M et al.. Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET.  AJR Am J Roentgenol. 2001;  177 229-236
• 30 Eary J F, O'Sullivan F, Powitan Y et al.. Sarcoma tumor FDG uptake measured by PET and patient outcome: a retrospective analysis.  Eur J Nucl Med Mol Imaging. 2002;  29 1149-1154
• 31 Jadvar H, Gamie S, Romanna L, Conti P S. Musculoskeletal system.  Semin Nucl Med. 2004;  34(4) 254-261
• 32 Feldman F, Van Heertum R, Saxena C. 18-Fluoro-deoxyglucose positron emission tomography evaluation of benign versus malignant osteochondromas: preliminary observations.  J Comput Assist Tomogr. 2006;  30(5) 858-864
• 33 Feldman F, Van Heertum R, Saxena C, Parisien M. 18-FDG-PET applications for cartilage neoplasms.  Skeletal Radiol. 2005;  34(7) 367-374
• 34 Brenner W, Conrad E U, Eary J F. FDG PET imaging for grading and prediction of outcome in chondrosarcoma patients.  Eur J Nucl Med Mol Imaging. 2004;  31(2) 189-195