Clinical application of dynamic 18F-fluorodeoxyglucose positron-emission tomography / computed tomography in the differential diagnoses of musculoskeletal lesions

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  • Shinya Takayoshi
    1Department of Radiology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan Division of Radiology, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Center, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
  • Otomi Yoichi
    1Department of Radiology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
  • Nishisho Toshihiko
    Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima-city, 770-8503, Tokushima, Japan
  • Beuthien-Baumann Bettina
    Division of Radiology, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
  • Irahara Saho
    1Department of Radiology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
  • Kubo Michiko
    1Department of Radiology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
  • Otsuka Hideki
    Department of Medical Imaging/Nuclear Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
  • Bando Yoshimi
    Division of Pathology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
  • Sairyo Koichi
    Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima-city, 770-8503, Tokushima, Japan
  • Harada Masafumi
    1Department of Radiology, Tokushima University Hospital. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan

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<p>We aimed to assess the differential diagnostic efficacy of dynamic F-18 fluorodeoxyglucose (FDG) positron emission tomography / computed tomography (PET / CT) and to evaluate the appropriate scan timings for diagnosis of musculoskeletal lesions (MSLs). Dynamic scans (5–15 [phase 1], 15–25 [phase 2], and 25–35 [phase 3] min after F-18 FDG injection) and dual-time-point scans (1 and 2 h after injection) were acquired for 23 MSLs [4 benign MSLs (BMSLs). 10 primary malignant musculoskeletal tumors (PMMSTs), and 9 metastatic musculoskeletal tumors (MMSTs)]. We compared the maximum standardized uptake values (SUVmax) and corresponding retention indices for dynamic (RI-SUVdyn) and dual-time-point (RI-SUVdual) scans and evaluated diagnostic efficacy using receiver operating characteristic (ROC) curve analyses. The SUVmax gradually decreased or was almost identical with minimal fluctuation in 3 BMSLs and 1 PMMST. SUVmax increased over time after phase 2 in 18 malignant MSLs (MMSLs). There were significant differences in SUVmax (for all time phases) and RI-SUV dual between BMSLs and MMSLs and between PMMSTs and MMSTs. In the ROC analyses, the areas under the curve for SUV in phases 2 and 3 were highest for differentiating BMSLs from MMSLs and PMMSTs from MMSTs, respectively. Dynamic F-18 FDG PET / CT is valuable for diagnosis of musculoskeletal lesions. J. Med. Invest. 68 : 96-104, February, 2021</p>

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