Diagnostic value of nuclide bone imaging for bone metastasis from lung cancer and clinic analysis

Abstract

Bone metastasis is very common in lung cancer patients. Metastasis to spine can lead to paralysis and fracture, deteriorate the quality of patient's life. The objective of this study is to investigate the diagnostic values of bone scanning (NBS), MRI, CT and X-ray examination to discover bone meastasis of lung cancer, and the therapy of bone metastasis and the prognostic factors. About 561 consecutive NSCLC cases were analyzed with NBS and compared with other radiological examinations (MRI, CT and X-ray). Out of the 455 positive patients by NBS, 300 cases were confirmed to be with bone metastases by dynamic follow-up, MRI, CT and X-ray, and 5 cases were false negative.The sensitivity and specificity of NBS was 98.36% and 39.45% respectively. The accuracy of NBS was 71.48%. Among the 305 patients with bone metastases, 23 patients had no records, 138 patients had bone pain, the incidence of asymptomatic bone metastasis was 47.21%. Multivariables analysis showed that asymptomatic bone metastasis, flat bone metastases, therapy with disodium pamidronate were significantly good prognostic factors, respectively (P < 0.05). A whole body NBS examination is preferred for the staging of NSCLC. NBS is necessary for patients with NSCLC. In order to exclude the possible false positive or false negative diagnosis by NBS, CT or MRI could be selected according to the sites of lesions.