The radiologic and FDG uptake findings of osseous lesions incidentally detected on 18F-FDG-PET/CT imaging

Background In routine clinical practice, incidental solitary bone lesions are commonly seen on various imaging modalities. 18F-FDG-positron emission tomography (PET)/computed tomography (CT) imaging provides functional and morphological information in oncology patients, and incidental bone lesions are often detected during the scan.Purpose To evaluate the metabolic characteristics and CT morphological findings of incidental bone lesions detected in patients undergoing 18F-FDG-PET/CT imaging.Material and Methods SUVmax values and CT characteristics of incidental osseous lesions reported in 86 patients undergoing 18F-FDG-PET/CT imaging between 2019 and 2023 were evaluated. In addition, the SUVmax values of the lesions were compared with bone areas without adjacent/contralateral density/FDG changes. CT characteristics of incidental osseous lesions were evaluated.Results The study group included 52 women and 34 men (age range = 26-89 years). CT identified typical bone haemangioma lesions in 45/86 (52%) cases. Non-haemangioma lesions were mainly benign bone pathologies: fibrous dysplasia; Paget's disease; perineural cyst; osteonecrosis; and osteoma. The mean SUVmax value of 41 non-haemangioma bone lesions (4.27 +/- 3.71) was significantly higher than that in adjacent/contralateral normal density areas (2.31 +/- 1.27; P = 0.01).Conclusion 18F-FDG-PET/CT imaging shows varying FDG uptake in incidental osseous lesions. Morphological features on CT play a critical role in diagnosis and avoiding unnecessary imaging or interventions.