Document Detail


Detection of bone metastases: assessment of integrated FDG PET/CT imaging.
MedLine Citation:
PMID:  17392254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively evaluate the positive predictive value (PPV) of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the identification of malignant bone lesions when the PET and CT findings are discordant and concordant. MATERIALS AND METHODS: The study conformed to HIPAA standards, and the need for informed consent was waived by the institutional review board that approved the study. FDG PET/CT reports of 712 patients were reviewed to identify patients with malignant bone lesions. Fifty-nine patients (30 female and 29 male patients; age range, 10-82 years) with 113 lesions were analyzed. With use of confirmation from histopathologic examination or clinical follow-up, the PPVs of the integrated examination and of the stand-alone CT and PET components of the examination were calculated. The results were stratified according to cancer type, chemotherapy status, and number of bone lesions and were compared by using Fisher exact tests. RESULTS: Of 47 lesions with positive findings at both PET and CT, 46 were malignant and one was benign, for a PPV of 98%. Of 31 lesions with positive findings at PET and negative findings at CT, 19 were malignant and 12 were benign, for a PPV of 61%. Of 35 lesions with negative findings at PET and positive findings at CT, six were malignant and 29 were benign, for a PPV of 17%. Independently, the PPV of all lesions with positive findings at PET was significantly higher than that of all lesions with positive findings at CT. Chemotherapy status for lesions with positive findings at CT and the number of lesions per patient had a statistically significant effect on the PPV of examinations (P = .02 and P < .001, respectively). CONCLUSION: PET/CT has a very high PPV for bone metastases (98%) when the findings at PET and CT are concordant; however, in lesions with discordant PET and CT findings at the integrated examination, PPV is markedly diminished.
Authors:
Al V Taira; Robert J Herfkens; Sam S Gambhir; Andrew Quon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  243     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-29     Completed Date:  2007-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology/Division of Nuclear Medicine, Molecular Imaging Program at Stanford, Stanford University Medical Center, CA 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Bone Neoplasms / radiography*,  radionuclide imaging*,  secondary
Child
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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