18 F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of spinal giant cell tumors
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SCIENTIFIC ARTICLE
18
F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of spinal giant cell tumors Le Song 1 & Songbo Han 2 & Weifang Zhang 1 & Liang Jiang 3 Received: 9 February 2020 / Revised: 29 April 2020 / Accepted: 10 May 2020 # ISS 2020
Abstract Objective To investigate the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the evaluation of spinal giant cell tumors (GCTs). Materials and methods The PET/CT and clinical data of 16 patients with spinal GCTs were reviewed. The maximal standardized uptake value (SUVmax), longest diameter, and CT features of spinal GCTs were analyzed. The value of PET/CT and MRI in displaying the recurrent lesions was compared. PET Response Criteria in Solid Tumors were adopted to evaluate the response to radiotherapy. Results Data from 7 males and 9 females (median age 32.5 years) were analyzed. Eight patients had primary GCTs with a median SUVmax of 11.91 and a median length of 4.42 cm. Eight patients had relapsed GCTs with a median SUVmax of 10.34 and a median length of 6.23 cm. There was no statistical difference between the SUVmax of primary and relapsed GCTs. The SUVmax did not correlate with length. In 8 relapsed patients, 4 lesions invaded the vertebral canal, but 2 of which were not displayed on MRI. Metal prostheses showed extremely low signal intensity on MRI, even in the 3 cases with increased intra-prosthetic 18FFDG concentration. Five relapsed patients with subsequent radiotherapy had a repeat PET/CT. A complete, partial, and stable metabolic response was observed in 1, 3, and 1 patient, respectively. Conclusions Both the primary and recurrent spinal GCTs avidly accumulate 18F-FDG. For recurrent GCTs, PET/CT may provide incremental value in the assessment of the vertebral canal and intra-prosthetic involvement and the response to radiotherapy. Keywords Vertebral . Giant cell tumors . PET/CT . 18F-fluorodeoxyglucose
Introduction Spinal giant cell tumors (GCTs) are locally aggressive primary osseous tumors, which are prone to the spinal canal and nerve invasion, causing pain, neurological dysfunction, and other
Le Song and Songbo Han contributed equally to this work. * Weifang Zhang [email protected] * Liang Jiang [email protected] 1
Department of Nuclear Medicine, Peking University Third Hospital, Beijing 100191, People’s Republic of China
2
Department of Radiology, Peking University Third Hospital, Beijing 100191, People’s Republic of China
3
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, People’s Republic of China
symptoms. Imaging studies are of great significance in the diagnosis, staging, and treatment planning of GCTs. Radiographically, GCTs mainly affect epiphyses of long bones, creating typically solitary, purely lytic masses. GCT involves the spine in approximately 7% of cases, with a prevalence in the sacrum [1]. CT scans provide a more accurate assessment of cortical thinning and penetration. MRI is useful in assessing the
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