(18)F-Fluorodeoxyglucose PET and PET/CT in Pediatric Musculoskeletal Malignancies.

Although uncommon, musculoskeletal malignancies are major contributors to morbidity and mortality in children and young adults. (18)F-Fluorodeoxyglucose (FDG)-PET can play an important role in disease management, including staging, assessing response to therapy, and evaluating for recurrence. Advantages of (18)F-FDG-PET and (18)F-FDG-PET/computed tomography (CT) include the capability to assess tumor activity and a large field of view that can include the whole body or torso. (18)F-FDG-PET does not always discriminate benign and malignant musculoskeletal lesion, but it can serve to guide diagnostic procedures, such as needle biopsy. In patients with osteosarcoma, FDG-PET/CT cannot replace a 99mTc-methyldiphosphonate bone scan for localization of skeletal metastases. FDG-PET may be useful for the evaluation of non-rhabdomyosarcoma sarcomas on a case-by-case basis. (18)F-FDG-PET or PET/CT is most useful for identifying sites of distant disease in patients with newly diagnosed or recurrent Ewing sarcoma, rhabdomyosarcoma, or osseous lymphoma.