TY - JOUR T1 - Location-based comparison of F-18 FDG PET and bone scan for detection of bone metastasis in patients with non-small cell lung cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 470P LP - 470P VL - 47 IS - suppl 1 AU - Min Jeong Chae AU - Gi Jeong Cheon AU - Byung Hyun Byun AU - Sang Woo Lee AU - Chang Woon Choi AU - Sang Moo Lim Y1 - 2006/05/01 UR - http://jnm.snmjournals.org/content/47/suppl_1/470P.1.abstract N2 - 1738 Objectives: There were several reports that FDG PET had better specificity and bone scan had higher sensitivity for detecting bone metastasis. We were apt to evaluate diagnostic superiority between FDG PET and bone scan in patients with non-small cell lung cancer (NSCLC) according to the location of bone metastasis. Methods: In this retrospective study, we reviewed 402 NSCLC patients who had undertaken both FDG PET and bone scan. The intervals between the two studies were less than 1 month. We analyzed PET and bone scan findings by a 5-point scales: most likely, more likely, equivocal, less likely, and least likely for bone metastasis. According to the location, bone lesions grouped into vertebra, pelvis, rib, sternum, scapula, skull, and long bone. We diagnosed bone metastasis whether it had proven on biopsy or there was consistency between the imaging modality (X-ray, CT, MRI, bone scan and PET) and clinical status at least three. Results: Fifty-three out of 402 patients with NSCLC (13.2%) had bone metastasis. Distribution of bony metastasis was 33% in vertebra, 31% in rib, 15% in pelvis, 8% in long bone, 5% in scapula, 5% in skull, and 3% in sternum. In lesion-based analysis, 98 out of 281 lesion groups (34.9%) had considered as metastasis. The overall sensitivity, specificity, and accuracy of FDG PET were 67%, 92%, and 83% and those of bone scan were 67%, 67% and 67%, respectively. FDG PET was more sensitive in vertebra, pelvis and long bone lesions. On the other hand, bone scan was more sensitive in the rib, skull, and scapula lesions. Upstaging patients with positive results was 68% in FDG PET and 86% in bone scan. In patients with early T-stage (T1 and T2, n=11), only 6 patients were positive on PET, whereas 11 patients were positive on bone scans. Conclusions: The overall diagnostic accuracy of FDG PET for detecting bone metastasis was superior to bone scan in patients with NSCLC. Bone scan had good diagnostic ability in rib, skull and scapula lesions. In addition, bone scan was more useful in upstaging by detection of bone metastasis, especially in early T-stage of NSCLC. ER -