18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

Kevin London, Claudia Stege, Siobhan Cross, Ella Onikul, Nicole Graf, Gertjan Kaspers, Luciano Dalla-Pozza, Robert Howman-Giles

Research output: Contribution to journalArticlepeer-review

54 Citations (Scopus)


Background: F-Fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. Objective: To compare hybrid FDG positron emission tomography/ computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Materials and methods: Retrospective analysis of PET/CT and CI reports with histopathology or follow-up>6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. Results: A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV max and greater SUV max reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. Conclusion: PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy.

Original languageEnglish
Pages (from-to)418-430
Number of pages13
JournalPediatric Radiology
Issue number4
Publication statusPublished - Apr 2012
Externally publishedYes


  • Bone neoplasm
  • Ewing sarcoma
  • FDG
  • Osteosarcoma
  • Positron emission tomography


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