Michael J Gelfand1, Susan E Sharp. 1. Department of Radiology, Nuclear Medicine Division, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229-3026, USA, michael.gelfand@cchmc.org.
Abstract
BACKGROUND: Metal endoprostheses and internal fixation devices cause significant artifacts on CT after limb salvage surgery; positron emission tomography (PET) images should be evaluated for artifacts. OBJECTIVE: (1) To describe [F-18]2-fluoro-2-deoxyglucose (FDG) PET uptake patterns after limb salvage surgery. (2) To determine whether metal endoprostheses and fixation hardware cause significant artifacts on CT attenuation-corrected PET that interfere with diagnostic use of PET/CT after limb salvage surgery. MATERIALS AND METHODS: We reviewed 92 studies from 18 patients ages 5-21 years. Diagnoses were osteogenic sarcoma in 14, Ewing sarcoma in 3, and malignant peripheral nerve sheath tumor originating in bone in 1. Nine patients had distal femur/knee endoprostheses, five had lower-extremity bone allografts secured by large metal plates and four had upper-extremity limb salvage procedures. Maximum standardized uptake value was calculated at lower-extremity soft-tissue-endoprosthesis interfaces. In 15 patients with PET/CT imaging, the first PET/CT scan after limb salvage surgery was reviewed for metal artifacts on CT images and for artifacts at locations on PET corresponding to the CT metal artifacts. RESULTS: Increased FDG uptake was consistently present at soft-tissue interfaces with endoprostheses, allografts and internal fixation devices, with little or no FDG uptake at cemented endoprosthesis-bone interfaces. Maximum standardized uptake value at margins of femur/knee endoprostheses ranged from 1.4 to 5.7. In four patients with distal femur/knee endoprostheses, minimal artifact was noted on attenuation-corrected PET images, but image interpretation was not affected. In the other 11 patients who had CT attenuation correction, we detected no artifacts caused by the attenuation correction. CONCLUSION: CT attenuation correction did not cause artifacts that affected interpretation of attenuation-corrected PET images.
BACKGROUND:Metal endoprostheses and internal fixation devices cause significant artifacts on CT after limb salvage surgery; positron emission tomography (PET) images should be evaluated for artifacts. OBJECTIVE: (1) To describe [F-18]2-fluoro-2-deoxyglucose (FDG) PET uptake patterns after limb salvage surgery. (2) To determine whether metal endoprostheses and fixation hardware cause significant artifacts on CT attenuation-corrected PET that interfere with diagnostic use of PET/CT after limb salvage surgery. MATERIALS AND METHODS: We reviewed 92 studies from 18 patients ages 5-21 years. Diagnoses were osteogenic sarcoma in 14, Ewing sarcoma in 3, and malignant peripheral nerve sheath tumor originating in bone in 1. Nine patients had distal femur/knee endoprostheses, five had lower-extremity bone allografts secured by large metal plates and four had upper-extremity limb salvage procedures. Maximum standardized uptake value was calculated at lower-extremity soft-tissue-endoprosthesis interfaces. In 15 patients with PET/CT imaging, the first PET/CT scan after limb salvage surgery was reviewed for metal artifacts on CT images and for artifacts at locations on PET corresponding to the CT metal artifacts. RESULTS: Increased FDG uptake was consistently present at soft-tissue interfaces with endoprostheses, allografts and internal fixation devices, with little or no FDG uptake at cemented endoprosthesis-bone interfaces. Maximum standardized uptake value at margins of femur/knee endoprostheses ranged from 1.4 to 5.7. In four patients with distal femur/knee endoprostheses, minimal artifact was noted on attenuation-corrected PET images, but image interpretation was not affected. In the other 11 patients who had CT attenuation correction, we detected no artifacts caused by the attenuation correction. CONCLUSION: CT attenuation correction did not cause artifacts that affected interpretation of attenuation-corrected PET images.
Authors: Stephen G Pill; Javad Parvizi; Peter H Tang; Jonathan P Garino; Charles Nelson; Hongming Zhuang; Abass Alavi Journal: J Arthroplasty Date: 2006-09 Impact factor: 4.757
Authors: Mehrsima Abdoli; Johan R de Jong; Jan Pruim; Rudi A J O Dierckx; Habib Zaidi Journal: Eur J Nucl Med Mol Imaging Date: 2011-08-18 Impact factor: 9.236
Authors: Monica Abella; Adam M Alessio; David A Mankoff; Lawrence R MacDonald; Juan Jose Vaquero; Manuel Desco; Paul E Kinahan Journal: Phys Med Biol Date: 2012-04-05 Impact factor: 3.609
Authors: Gerhard W Goerres; Sibylle I Ziegler; Cyrill Burger; Thomas Berthold; Gustav K Von Schulthess; Alfred Buck Journal: Radiology Date: 2003-02 Impact factor: 11.105
Authors: Marc Schiesser; Katrin D M Stumpe; Otmar Trentz; Thomas Kossmann; Gustav K Von Schulthess Journal: Radiology Date: 2003-02 Impact factor: 11.105