FDG PET of primary benign and malignant bone tumors: Standardized uptake value in 52 lesions

PURPOSE: To evaluate the standardized uptake value (SUV)of 2-[fluorine-18]- puoro-2-deoxy-D-glucose (FDG) at positron emission tomography (PET) in the differentiation of benign from malignant bone lesions. MATERIALS AND METHODS: Fifty-two (19 malignant, 33 benign) primary bone les ions were examined with FDG PET prior to tissue diagnosis. The SUVs were ca lculated and compared between benign and malignant lesions and among histol ogic subgroups that included more than four cases. RESULTS: There was a statistically significant difference in SUV between be nign (2.18 +/- 1.52 [SD]) and malignant (4.34 +/- 3.19) lesions in total (P = .002). However, giant cell tumors (n = 5; SUV, 4.64 +/- 1.05) showed sig nificantly higher SUV than chondrosarcomas (n = 7; SUV, 2.23 +/- 0.74) (P = .036, adjusted for multiple comparisons) and had no statistically signific ant difference in SUV compared with osteosarcomas (n = 6; SUV, 3.07 +/- 0.9 6) (P = .171). There was no statistically significant difference in SUV bet ween fibrous dysplasias (n = 6; SUV, 2.05 +/- 0.98) and osteosarcoma (P = . 127) or chondrosarcomas (P = .667). Although the number of cases was small, three chondroblastomas, one sarcoidosis, and one Langerhans cell histiocyt osis showed levels of FDG accumulation as high as that of osteosarcomas. CONCLUSION: Radiologists should be aware of the high accumulation of FDG in some benign bone lesions, especially histiocytic or giant cell-containing lesions. Consideration of histologic subtypes should be included in analysi s of SUV at FDG PET of primary bone tumors.