gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015)

20.10. - 23.10.2015, Berlin

The accuracy of 18F-Florodeoxyglucose Positron Emission Tomography /Computed Tomography in the evaluation of bone lesions of undetermined origin

Meeting Abstract

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  • presenting/speaker Cuneyt Tamam - Tatvan Military Hospital, Orthopaedic Surgery, Bitlis, Turkey
  • Muge Tamam - Okmeydani Training and Research Hospital,, Department of Nuclear Medicine, Istanbul, Turkey
  • Mehmet Mulazimoglu - Okmeydani Training and Research Hospital,, Department of Nuclear Medicine, Istanbul, Turkey
  • Tulay Guveli - Okmeydani Training and Research Hospital,, Department of Nuclear Medicine, Istanbul, Turkey

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015). Berlin, 20.-23.10.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocPO14-770

doi: 10.3205/15dkou604, urn:nbn:de:0183-15dkou6042

Veröffentlicht: 5. Oktober 2015

© 2015 Tamam et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

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Objectives: The definition of carcinoma of unknown primary includes patients who have histologically confirmed metastatic cancer in whom a detailed medical history, complete physical examination including pelvic and rectal examination, full blood count and biochemistry, urinalysis and stool occult blood testing, histopathological review of biopsy material with the use of immunohistochemistry, chest radiography, computed tomography of the abdomen and pelvis and, in certain cases,mammography fail to identify the primary site.

The skeleton, especially its axial and proximal appendicular portion, is a common site for metastases . Clinically, skeletal metastasis of unknown origin is suspected in patients who are a symptomatic, osteolytic skeletal lesion with poor margination, and who are more than forty years old.

Conventional imaging modalities; Computed tomography, magnetic resonance imaging, and ultrasound provide mainly morphologic information on the primary tumor and potential metastases. The radiotracer Fluorine-18(18F)-fluorodeoxyglucose positron emission tomography provides functional data on tumor metabolism. Hybrid Imaging by FDG-PET/CT enhance the diagnostic capability of detecting the primary tumor by fusing morphologic and functional data. FDG-PET/CT has the capacity to detect different tumor types in whole-body noninvasively and in a single examination.

The aim of the current study was to determine the diagnostic accuracy of whole-body fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in detecting carcinoma of unknown primary with bone metastases.

Methods: We evaluated 87 patients who were referred to FDG-PET/CT imaging reported to have skeletal lesions with suspicion of malignancy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. The Kaplan-Meier test was used for survival analysis. Median survival rate was measured to evaluate the prognostic value of the FDG-PET/CT findings.

Results: In the search for a primary, FDG-PET/CT findings correctly diagnosed lesions as the site of the primary true positive in 64(73%) cases, 4(5%) findings diagnosed no site of a primary and none was subsequently proven true negative, 14(16%) diagnoses were false positive and 5(6%) were false negative.

Conclusion: Although the histopathologic verification is golden standard, Whole-body FDG-PET/CT imaging is proven to be an useful method in assessing the bone lesions with suspicion of bone metastases.