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Abstract Summary and conclusions Among human neoplasms, primary malignant bone tumors are fairly rare. The most common primary malignant bone tumors are osteosarcoma, chondrosarcoma, and Ewing’s sarcoma. Staging of the lesion is essential for systemic therapeutic decision-making and hence follow up of the disease and find out how it responds to treatment as well. This includes complete imaging and histo-pathological confirmation of the suspected entity. Although the combined/hybrid device is considerably more expensive than other imaging modalities, it has the advantage of providing functional imaging obtained by PET, which depicts the spatial distribution of metabolic or biochemical activity in the body and correlating it with anatomic imaging obtained by CT scanning in the same session. This study aimed at studying the role of positron emission tomographycomputed tomography (PET-CT) using 18F-FDG in primary malignant bone tumors including the staging of primary malignant bone tumors, detecting the sensitivity, specificity and accuracy of PET/CT in assessment of treatment response and detection of residual or recurrent disease. The current study included 40 patients selected randomly among patients referred to diagnostic radiology and medical imaging department in Nasser Institute for Research and Treatment and Tanta university hospital and proven by biopsy to have primary malignant bone tumors. All the patients were subjected to proper history taking: personal history, complaint of the patient which varied according to the site of malignancy (with fatigue and weight loss are the most common clinical presentation), past history of any systemic diseases or other previous malignancies, focused history on the current tumor (histopathological findings and previous treatment including |