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A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and (99m)Tc-MDP whole-body bone scanning for imaging osteolytic bone metastases.

Zhang L, Chen L, Xie Q, Zhang Y, Cheng L, Li H, Wang J - BMC Med Imaging (2015)

Bottom Line: The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.It was found that (99m)Tc-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).F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. linzhangswh@yahoo.com.

ABSTRACT

Background: 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 (99m)Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.

Methods: Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and (99m)Tc-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.

Results: The 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 (99m)Tc-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).

Conclusions: F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

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Related in: MedlinePlus

A 32-year-old man with an unknown primary lesion and multiple bone metastases. There was no focally increased uptake detected in the bone scanning (BS) image (A). PET-CT revealed that the bone substance of the ninth thoracic vertebral body and its adjunct, the third lumbar vertebral body and left ilium, was destroyed. 18FDG uptake in these areas was significantly increased. The maximum standardized uptake value is 3.96 (B and C). More metastatic lesions were detected using 18F-FDG PET-CT than 99mTc-MDP BS.
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Fig2: A 32-year-old man with an unknown primary lesion and multiple bone metastases. There was no focally increased uptake detected in the bone scanning (BS) image (A). PET-CT revealed that the bone substance of the ninth thoracic vertebral body and its adjunct, the third lumbar vertebral body and left ilium, was destroyed. 18FDG uptake in these areas was significantly increased. The maximum standardized uptake value is 3.96 (B and C). More metastatic lesions were detected using 18F-FDG PET-CT than 99mTc-MDP BS.

Mentions: The characteristics of all of the included patients are detailed in Table 1. The median age of the patients was 57 (range, 25–77) years. A total of 422 skeletal areas were analyzed for lesions in 34 patients. In total, 405 lesions were confirmed as osteolytic metastases. The distribution and number of lesions are shown in Table 2. 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). There was a significant difference in the number of lesions detected in different skeletal areas using PET/CT and BS. In total, 18F-FDG PET/CT was used to detect 383 positive lesions and 23 false-negative lesions, yielding a sensitivity of 94.3% (95% confidence interval [CI], 91.6–96.2%); BS was used to detect 204 positive lesions and 202 false-negative lesions, yielding a sensitivity of 50.2% (95% CI, 45.4–55.1%). 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 false-positive lesions; the specificities of the two methods were 83.3% (95% CI, 43.6–96.9%) and 50.0% (95% CI, 18.8–81.2%), respectively. The diagnostic accuracies of 18F-FDG PET/CT and 99mTc-MDP whole-body BS were 94.2% (95% CI, 91.5–96.1%) and 50.2% (95% CI, 45.5–55.1%), respectively. There were significant differences in the sensitivity, specificity, and accuracy (all p<0.001) of these modalities, indicating that 18F-FDG PET/CT was more accurate than BS in the present study (Table 2). 18F-FDG PET/CT showed higher sensitivity than 99mTc-MDP BS in detecting osteolytic bone metastases in the cervical vertebra, thoracic vertebra, lumbar vertebra, and ribs (Table 3; all p<0.001). The subgroups were created in terms of tumor types and bone areas; the sensitivity estimates for the different subgroups are presented in Table 4.Table 1


A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and (99m)Tc-MDP whole-body bone scanning for imaging osteolytic bone metastases.

Zhang L, Chen L, Xie Q, Zhang Y, Cheng L, Li H, Wang J - BMC Med Imaging (2015)

A 32-year-old man with an unknown primary lesion and multiple bone metastases. There was no focally increased uptake detected in the bone scanning (BS) image (A). PET-CT revealed that the bone substance of the ninth thoracic vertebral body and its adjunct, the third lumbar vertebral body and left ilium, was destroyed. 18FDG uptake in these areas was significantly increased. The maximum standardized uptake value is 3.96 (B and C). More metastatic lesions were detected using 18F-FDG PET-CT than 99mTc-MDP BS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358702&req=5

Fig2: A 32-year-old man with an unknown primary lesion and multiple bone metastases. There was no focally increased uptake detected in the bone scanning (BS) image (A). PET-CT revealed that the bone substance of the ninth thoracic vertebral body and its adjunct, the third lumbar vertebral body and left ilium, was destroyed. 18FDG uptake in these areas was significantly increased. The maximum standardized uptake value is 3.96 (B and C). More metastatic lesions were detected using 18F-FDG PET-CT than 99mTc-MDP BS.
Mentions: The characteristics of all of the included patients are detailed in Table 1. The median age of the patients was 57 (range, 25–77) years. A total of 422 skeletal areas were analyzed for lesions in 34 patients. In total, 405 lesions were confirmed as osteolytic metastases. The distribution and number of lesions are shown in Table 2. 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). There was a significant difference in the number of lesions detected in different skeletal areas using PET/CT and BS. In total, 18F-FDG PET/CT was used to detect 383 positive lesions and 23 false-negative lesions, yielding a sensitivity of 94.3% (95% confidence interval [CI], 91.6–96.2%); BS was used to detect 204 positive lesions and 202 false-negative lesions, yielding a sensitivity of 50.2% (95% CI, 45.4–55.1%). 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 false-positive lesions; the specificities of the two methods were 83.3% (95% CI, 43.6–96.9%) and 50.0% (95% CI, 18.8–81.2%), respectively. The diagnostic accuracies of 18F-FDG PET/CT and 99mTc-MDP whole-body BS were 94.2% (95% CI, 91.5–96.1%) and 50.2% (95% CI, 45.5–55.1%), respectively. There were significant differences in the sensitivity, specificity, and accuracy (all p<0.001) of these modalities, indicating that 18F-FDG PET/CT was more accurate than BS in the present study (Table 2). 18F-FDG PET/CT showed higher sensitivity than 99mTc-MDP BS in detecting osteolytic bone metastases in the cervical vertebra, thoracic vertebra, lumbar vertebra, and ribs (Table 3; all p<0.001). The subgroups were created in terms of tumor types and bone areas; the sensitivity estimates for the different subgroups are presented in Table 4.Table 1

Bottom Line: The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.It was found that (99m)Tc-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).F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. linzhangswh@yahoo.com.

ABSTRACT

Background: 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 (99m)Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.

Methods: Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and (99m)Tc-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.

Results: The 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 (99m)Tc-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).

Conclusions: F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

Show MeSH
Related in: MedlinePlus