Prognostic Significance of 18F-FDG and 99mTc-Methylene Diphosphonate Uptake in Primary Osteosarcoma

Journal of Nuclear Medicine

Otmar Schober¹  Silke Flege¹  Joachim Sciuk¹  Heribert Jürgens¹  Christiane Franzius¹  Stefan Bielack¹ 

关键词: ¹⁸F-FDG PET;    ^99mTc-methylene diphosphonate bone scintigraphy;    osteosarcoma;    prognosis;    glucose metabolism;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The purpose of this retrospective analysis was to evaluate the prognostic significance of both initial glucose metabolism as measured by 18F-FDG PET and osteoblastic activity as measured by 99mTc-methylene diphosphonate (MDP) bone scintigraphy in osteosarcoma. Methods: In 29 patients (18 male, 11 female; age range, 5–41 y) with primary osteosarcoma, 18F-FDG uptake and 99mTc-MDP uptake were measured semiquantitatively (average and maximum tumor-to-nontumor ratios [T/NTav and T/NTmax, respectively]) using PET and bone scintigraphy at the time of diagnosis. After chemotherapy, the patients underwent surgery for their primary tumor, and the response was determined histologically. Cumulative overall survival and event-free survival were determined by clinical and imaging follow-up of 7–72 mo (median, 28 mo). Results: Clinical and imaging follow-up revealed that the disease relapsed or failed to achieve complete remission in 9 patients and that 6 patients died of the disease. Both overall and event-free survival were significantly better in patients with a low 18F-FDG T/NTmax (less than the median) than in patients with a high 18F-FDG T/NTmax (at least the median). The negative relationship of 18F-FDG T/NTav, 99mTc-MDP T/NTmax, and 99mTc-MDP T/NTav with overall and event-free survival did not reach a level of significance. 18F-FDG uptake values correlated moderately and positively with 99mTc-MDP uptake values, but a level of significance was reached only between 18F-FDG T/NTmax and 99mTc-MDP T/NTav. Conclusion: The initial glucose metabolism of primary osteosarcoma as measured by 18F-FDG PET using T/NTmax provides prognostic information. High 18F-FDG uptake correlates with poor outcome. Thus, 18F-FDG uptake may be complementary to other well-known factors in judging the prognosis in osteosarcoma.

【 授权许可】

Unknown