TY - JOUR T1 - Prospective Evaluation of the Clinical Value of Planar Bone Scans, SPECT, and <sup>18</sup>F-Labeled NaF PET in Newly Diagnosed Lung Cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1800 LP - 1804 VL - 42 IS - 12 AU - Holger Schirrmeister AU - Gerhard Glatting AU - Jürgen Hetzel AU - Karin Nüssle AU - Coskun Arslandemir AU - Andreas K. Buck AU - Kerstin Dziuk AU - Andreas Gabelmann AU - Sven N. Reske AU - Martin Hetzel Y1 - 2001/12/01 UR - http://jnm.snmjournals.org/content/42/12/1800.abstract N2 - Previous studies have shown that vertebral bone metastases (BM) not seen on planar bone scintigraphy (BS) might be present on 18F-fluoride PET scans or at MRI. Therefore, we evaluated the effect of SPECT or 18F-labeled NaF PET (18F PET) imaging on the management of patients with newly diagnosed lung cancer. Methods: Fifty-three patients with small cell lung cancer or locally advanced non–small cell lung cancer were prospectively examined with planar BS, SPECT of the vertebral column, and 18F PET. MRI and all available imaging methods, as well as the clinical course, were used as reference methods. BS with and without SPECT and 18F PET were compared using a 5-point scale for receiver operating characteristic (ROC) curve analysis. Results: Twelve patients had BM. BS produced 6 false-negatives, SPECT produced 1 false-negative, and 18F PET produced no false-negatives. The area under the ROC curve was 0.779 for BS, 0.944 for SPECT, and 0.993 for 18F PET. The areas under the ROC curve of 18F PET and BS complemented by SPECT were not significantly different, and both tomographic methods were significantly more accurate than planar BS. As a result of SPECT or 18F PET imaging, clinical management was changed in 5 patients (9%) or 6 patients (11%), respectively. Conclusion: As indicated by the area under the ROC curve analysis, 18F PET is the most accurate whole-body imaging modality for screening for BM. Routinely performed SPECT imaging is practicable, is cost-effective, and improves the accuracy of BS. ER -