Hassan Shihabul, Suvarna Rishabh, Uldin Hasaam, Hussein Mohsin, Botchu Rajesh
Department of General Medicine, Buckinghamshire Healthcare NHS Trust, Aylesbury HP21 8AL, UK.
School of Medicine, Worsely Building, University of Leeds, Leeds LS2 9JT, UK.
J Clin Med. 2025 Apr 11;14(8):2624. doi: 10.3390/jcm14082624.
Primary malignant bone tumours can pose significant diagnostic and therapeutic challenges due to inter-tumour heterogeneity. While traditional imaging modalities such as radiography, MRI (magnetic resonance imaging), and CT (computed tomography) remain essential for initial evaluation and staging, emerging evidence underscores the evolving role of positron emission tomography (PET), particularly PET/CT with Fluorodeoxyglucose ([18F] FDG), in the comprehensive management of bone sarcomas. This narrative review aims to critically summarise the available literature on PET imaging's utility in the management of primary bone tumours including osteosarcoma, chondrosarcoma, and Ewing sarcoma. Despite limitations like inconsistencies in standard uptake value (SUV) cutoffs and reduced pulmonary resolution, PET/CT is valuable for staging, assessing response to neoadjuvant chemotherapy, predicting histological outcomes, detecting recurrence, and guiding biopsy in metabolically active tumour sites. Further large-scale, prospective studies are warranted to standardise protocols and establish PET's definitive role in sarcoma management.
由于肿瘤间的异质性，原发性恶性骨肿瘤会带来重大的诊断和治疗挑战。虽然传统的成像方式，如X线摄影、MRI（磁共振成像）和CT（计算机断层扫描）对于初始评估和分期仍然至关重要，但新出现的证据强调了正电子发射断层扫描（PET），尤其是氟脱氧葡萄糖（[18F] FDG）PET/CT在骨肉瘤综合管理中不断演变的作用。这篇叙述性综述旨在批判性地总结关于PET成像在原发性骨肿瘤（包括骨肉瘤、软骨肉瘤和尤因肉瘤）管理中的应用的现有文献。尽管存在标准摄取值（SUV）临界值不一致和肺部分辨率降低等局限性，但PET/CT对于分期、评估新辅助化疗的反应、预测组织学结果、检测复发以及在代谢活跃的肿瘤部位指导活检都很有价值。需要进一步开展大规模的前瞻性研究，以规范方案并确定PET在肉瘤管理中的明确作用。
