Comparison studies between PET imaging alone versus CT acquired during FDG- PET/CT have been reported, although the CT acquired for attenuation correction and anatomic registration is not regarded as equivalent to dedicated diagnostic CT chest imaging [13]. Roberge et al [14] compared FDG-PET/CT with conventional imaging in a cohort of 109 patients during staging of extremity and body wall soft tissue sarcomas. In this cohort, 16 of the 109 patients had lung metastases, 10 of which were only identified on CT chest. Only 1 of the 16 patients with lung metastases was identified with FDG-PET/CT imaging but not CT chest. The authors concluded that FDG-PET/CT added little benefit over CT chest alone in evaluating for pulmonary metastasis [14]. A study comparing staging and follow-up imaging studies in 41 children with primary bone sarcomas showed greater sensitivity of CT chest (93%) versus FDG-PET/CT (80%) in detecting pulmonary metastases (although 4 Malignant or Aggressive Primary Musculoskeletal Tumor specificity was higher with FDG-PET/CT at 96% compared with 87% for CT chest). Of the false-negative FDG- PET/CT results in that study, half were pulmonary nodules <10 mm [15]. Evaluation of subcentimeter pulmonary nodules is a known limitation of FDG-PET/CT because of the inherent resolution constraints of PET/CT technology and respiratory motion artifact. However, a study of 63 lung nodules in 18 pediatric patients with bone sarcoma did demonstrate the value of using an FDG-PET standardized uptake value (SUV) cutoff in evaluating small pulmonary nodules; using an SUVmax >1 cutoff value and a nodule diameter cutoff of 6 mm can differentiate benign and malignant nodules with an accuracy of 92.1% compared with an accuracy of 88.9% with FDG-PET/CT visual analysis alone [16]. FDG-PET/MRI Whole Body Literature specific to sarcoma staging with FDG-PET/MRI is scarce.
Malignant or Aggressive Primary Musculoskeletal Tumor Staging And Surveillance PCAs. Comparison studies between PET imaging alone versus CT acquired during FDG- PET/CT have been reported, although the CT acquired for attenuation correction and anatomic registration is not regarded as equivalent to dedicated diagnostic CT chest imaging [13]. Roberge et al [14] compared FDG-PET/CT with conventional imaging in a cohort of 109 patients during staging of extremity and body wall soft tissue sarcomas. In this cohort, 16 of the 109 patients had lung metastases, 10 of which were only identified on CT chest. Only 1 of the 16 patients with lung metastases was identified with FDG-PET/CT imaging but not CT chest. The authors concluded that FDG-PET/CT added little benefit over CT chest alone in evaluating for pulmonary metastasis [14]. A study comparing staging and follow-up imaging studies in 41 children with primary bone sarcomas showed greater sensitivity of CT chest (93%) versus FDG-PET/CT (80%) in detecting pulmonary metastases (although 4 Malignant or Aggressive Primary Musculoskeletal Tumor specificity was higher with FDG-PET/CT at 96% compared with 87% for CT chest). Of the false-negative FDG- PET/CT results in that study, half were pulmonary nodules <10 mm [15]. Evaluation of subcentimeter pulmonary nodules is a known limitation of FDG-PET/CT because of the inherent resolution constraints of PET/CT technology and respiratory motion artifact. However, a study of 63 lung nodules in 18 pediatric patients with bone sarcoma did demonstrate the value of using an FDG-PET standardized uptake value (SUV) cutoff in evaluating small pulmonary nodules; using an SUVmax >1 cutoff value and a nodule diameter cutoff of 6 mm can differentiate benign and malignant nodules with an accuracy of 92.1% compared with an accuracy of 88.9% with FDG-PET/CT visual analysis alone [16]. FDG-PET/MRI Whole Body Literature specific to sarcoma staging with FDG-PET/MRI is scarce.