Comparative Study Between 99mTc-MDP Bone Scintigraphy and 18F-FDG PET/CT in the Staging of Adolescent Osteosarcoma: A Case Series

Abstract

Background: Children and adolescents primarily develop osteosarcoma, the most common malignant primary bone tumor. Adequate first-time staging is important to sustain the appropriate treatment and estimate prognosis. Bone scintigraphy with 18F-FDG, and those of 99mTc-MDP, have each been separately documented to evaluate the degree of skeletal involvement and metastatic spread. The difference in the contribution of these modalities is documented to some extent.

Objective: This study hopes to outline and document the differences between 99mTc-MDP bone scintigraphy and 18F-FDG PET/CT in the first staging of osteosarcoma on adolescents.

Methods: The study was focused on four identified cases of osteosarcoma treated at Cheikh Khalifa International University Hospital. A retrospective descriptive case series becomes applicable. Each of the four studied cases was subjected to 99mTc-MDP bone scintigraphy and 18F-FDG PET/CT. Standard clinical procedures were adhered to. The imaging findings were assessed for primary tumor, reference to local and regional extension, and distant metastasis.

Results: Osteosarcoma lesions were identified by bone scintigraphy. PET/CT was documented to be better in assessing local extension and soft tissue as well as in the distant metastatic lesion evaluation. In 2 of the studied cases, bone scintigraphy failed to detect lesions, and PET/CT documented evidence of metastatic lesions. In each of the 2 cases discrepancy was documented, the additional information from the PET/CT may influence the course of the treatment.

Conclusion: Osteosarcoma of adolescents is best documented and evaluated by the combined use of both radiation modalities in the early staging and treatment processes.

Keywords: Osteosarcoma; PET/CT; 18F-FDG; Bone Scintigraphy; 99mTc-MDP; Pediatric Oncology; Nuclear Medicine.

Received Date: April 21, 2026

Accepted Date: May 12, 2026

Published Date: June 01, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/732