Abstract
BackgroundThe objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 99mTc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.MethodsThirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and 99mTc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.ResultsThe sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6–96.2%), 83.3% (95% CI, 43.6–96.9%), and 94.2% (95% CI, 91.5–96.1%), respectively. It was found that 99mTc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4–55.1%) sensitivity, 50.0% (95% CI, 18.8–81.2%) specificity, and 50.2% (95% CI, 45.5–55.1%) accuracy. 18F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001).ConclusionsF-FDG PET/CT has a higher diagnostic value than 99mTc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.
Highlights
The objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 99mTc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases
The two imaging methods that we evaluated were better at detecting lesions, and a greater number of malignant lesions were revealed using 18FDG-PET/CT (Figure 2; Table 1)
Using PET/CT imaging, five negative lesions and one false-positive lesion was identified among the six benign lesions, while the BS images indicated three negative and three falsepositive lesions; the specificities of the two methods were 83.3% and 50.0%, respectively
Summary
The objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 99mTc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases. A number of different modalities have proven valuable in the detection of bone metastases; all noninvasive techniques currently in use have certain weaknesses [3]. 99mTc- methylenediphosphonate (MDP) wholebody bone scanning (BS) is a conventional method used. There is still no clear explanation for the differences between BS and 18F-FDG PET; we have undertaken a retrospective comparative study of 18F-FDG PET/CT and 99mTc-MDP whole-body bone scan data. Data from 34 patients with pathology-proven malignancies and suspected osteolytic bone metastases were analyzed to determine the clinical value of the two imaging methods
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