Overall, 39% more bone lesions in this study were identified with MRI whole body versus FDG-PET/CT [35]. In the Quartuccio et al [22] study of 64 pediatric patients with bone sarcoma, when FDG- PET/CT was compared with MRI for the detection of bone metastases, accuracy was similar (85% versus 89%). MRI better discriminates bone metastases from hematopoietic marrow, both of which can have increased metabolic activity on PET imaging. An advantage of PET over MRI is the ability to quantify tumor metabolic activity, which can serve as a prognostic indicator [15]. FDG-PET/CT can also be useful to detect nonskeletal metastases, more frequently in the lung, but also lymph nodes and other organs. FDG-PET/CT can detect a greater number of nodal metastases in soft tissue sarcoma versus conventional imaging alone [36,37]. The incidence of nodal metastases is dependent on tumor histology. FDG-PET/MRI Whole Body Literature specific to sarcoma staging with FDG-PET/MRI is scarce. A study of 29 patients with sarcoma who underwent FDG-PET/MRI and conventional imaging (CT chest/abdomen and/or local MRI) showed no significant difference in accuracy for detecting metastases with sensitivities and specificities of 97.8% and 100% for FDG- PET/MRI compared with 94.4% and 100% for conventional imaging. Of the 10 patients in this study with metastases, 6 had extrapulmonary metastases [17]. Another study of 98 bone lesions in a general oncologic population undergoing simultaneous FDG-PET/CT and FDG-PET/MRI showed these modalities to be equivalent for the detection and characterization of bone lesions [38]. Although FDG-PET/MRI whole body scans may prove to be useful in this setting, additional evidence is needed to compare its utility with existing modalities. Fluoride PET/CT Whole Body Fluoride PET/CT can increase diagnostic confidence when detecting bone metastases in general oncologic populations when compared with planar Tc-99m bone scans [39].
Malignant or Aggressive Primary Musculoskeletal Tumor Staging And Surveillance PCAs. Overall, 39% more bone lesions in this study were identified with MRI whole body versus FDG-PET/CT [35]. In the Quartuccio et al [22] study of 64 pediatric patients with bone sarcoma, when FDG- PET/CT was compared with MRI for the detection of bone metastases, accuracy was similar (85% versus 89%). MRI better discriminates bone metastases from hematopoietic marrow, both of which can have increased metabolic activity on PET imaging. An advantage of PET over MRI is the ability to quantify tumor metabolic activity, which can serve as a prognostic indicator [15]. FDG-PET/CT can also be useful to detect nonskeletal metastases, more frequently in the lung, but also lymph nodes and other organs. FDG-PET/CT can detect a greater number of nodal metastases in soft tissue sarcoma versus conventional imaging alone [36,37]. The incidence of nodal metastases is dependent on tumor histology. FDG-PET/MRI Whole Body Literature specific to sarcoma staging with FDG-PET/MRI is scarce. A study of 29 patients with sarcoma who underwent FDG-PET/MRI and conventional imaging (CT chest/abdomen and/or local MRI) showed no significant difference in accuracy for detecting metastases with sensitivities and specificities of 97.8% and 100% for FDG- PET/MRI compared with 94.4% and 100% for conventional imaging. Of the 10 patients in this study with metastases, 6 had extrapulmonary metastases [17]. Another study of 98 bone lesions in a general oncologic population undergoing simultaneous FDG-PET/CT and FDG-PET/MRI showed these modalities to be equivalent for the detection and characterization of bone lesions [38]. Although FDG-PET/MRI whole body scans may prove to be useful in this setting, additional evidence is needed to compare its utility with existing modalities. Fluoride PET/CT Whole Body Fluoride PET/CT can increase diagnostic confidence when detecting bone metastases in general oncologic populations when compared with planar Tc-99m bone scans [39].