Pediatric Radiology

, Volume 47, Issue 13, pp 1800–1808 | Cite as

FDG PET/CT appearance of local osteosarcoma recurrences in pediatric patients

  • Susan E. SharpEmail author
  • Barry L. Shulkin
  • Michael J. Gelfand
  • M. Beth McCarville
Original Article



Osteosarcoma is the most common pediatric malignant bone tumor, frequently surgically managed with limb salvage rather than amputation. Local recurrences are seen in up to 9% of osteosarcoma patients, with CT and MRI imaging often limited by metal artifacts.


To describe the [F-18]2-fluoro-2-deoxyglucose (FDG) PET/CT appearance of local osteosarcoma recurrences with correlation to findings on other imaging modalities.

Materials and methods

A retrospective review of pediatric osteosarcoma patients imaged with FDG PET/CT was performed in patients with pathologically proven local recurrences. FDG PET/CT findings were reviewed and correlated with available comparison imaging studies.


Ten local osteosarcoma recurrences in eight pediatric osteosarcoma patients were imaged with FDG PET/CT. All eight patients had a local recurrence after limb salvage; two patients had a second local recurrence after amputation. All local recurrences were seen with FDG PET/CT, demonstrating solid (n=5) or peripheral/nodular (n=5) FDG uptake patterns. Maximum standard uptake values (SUVs) ranged from 3.0 to 15.7. In five recurrences imaged with FDG PET/CT and MRI, MRI was limited or nondiagnostic in three. In four recurrences imaged with FDG PET/CT and bone scan, the bone scan was negative in three.


Local osteosarcoma recurrences are well visualized by FDG PET/CT, demonstrating either solid or peripheral/nodular FDG uptake with a wide range of maximum SUVs. FDG PET/CT demonstrates the full extent of local recurrences, while MRI can be limited by artifact from metallic hardware. PET/CT appears to be more sensitive than bone scan in detecting local osteosarcoma recurrences.


Children Fluorodeoxyglucose positron emission tomography/computed tomography Local recurrence Osteosarcoma 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Susan E. Sharp
    • 1
    Email author
  • Barry L. Shulkin
    • 2
  • Michael J. Gelfand
    • 1
  • M. Beth McCarville
    • 2
  1. 1.Department of RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Department of Diagnostic ImagingSt. Jude Children’s Research HospitalMemphisUSA

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