Comparison of the value of 99 Tc m -MDP bone scintigraphy, 99 Tc m -MDP SPECT-CT and 18 F-FDG SPECT-CT in detecting bone metastases of spine

Abstract

Objective To co mpare the value of 99Tcm-methylene diphosphonate (99Tcm-MDP)bone scintigraphy, 99Tcm-MDP SPECT-CT and 18F-FDG in detecting bone metastases of spine. Methods Retro-spective analysis of 88 tumor patients who underwent 99Tcm-MDP planar bone scintigraphy, then performed 99Tcm-MDP SPECT-CT immediately, and then underwent 18F-FDG SPECT-CT within 2 weeks apart. The diagnostic results were confirmed by biopsy, MRI/CT and clinical follow-up. Results Fouty-eight of 88 patients were comfirmed to be spine bone metastases, 19 to be spine benigns, 21 to be non-metastases. The sensitivity, specificity, positivity predicitive value, negative predictive value, and accuracy of 99Tcm-MDP bone scintigraphy were 89.6%(43/48), 62.5%(25/40), 74.1% (43/58), 83.3% (25/30)and 63.4%(68/88). Those of 9Tcm-MDP SPECTCT were 93.8% (45/48), 92.5%(35/40), 90.0% (45/50), 92.1% (35/38)and 81.6%(80/88). Those of 18F-FDG SPECT-CT were 97.9% (47/48), 97.5% (39/40), 97.9% (48/49), 97.5% (39/40)and 87.8% (86/88). SPECT-CT is resolving the problem in conventional bone scintigraphy on anatomical localization of the positive lesions on bone, and reducing the false positive rate. 18F-FDG SPECT-CT is more specific than 99Tcm-MDP bone scintigraphy to the bone metastases of spine, and increasing the ability to identify bone lesion malignant or benign, and increasing the specificity(X2=15.313, P＜0.001 ) and accuracy(X2=16.831, P＜0.001 ). Conclusion The diagnostic accuracy of 99Tcm-MDP SPECT-CTand 18F-FDG SPECT-CTin detecting bone metastases of spine are both better than 99Tcm-MDP BS.They are valuable for detecting bone metastases of spine. Key words: Spine; Neoplasm metastasis; Tomography, emission-computed, single-photon; Tomography, X-ray computed; Fluorodeoxyglucose F18; Technetium Tc 99m medronate