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Comparison of18FDG-PET with99mTc-HMDP scntigraphy for the detection of bone metastases in patients with breast cancer

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Abstract

Objective

Bone is one of the most common sites of metastasis in breast cancer patients. Although bone scintigraphy is widely used to detect metastatic breast cancer, the usefulness of18FDG-PET for detecting bone metastasis has not been clearly evaluated. The purpose of this study was to compare the diagnostic accuracy of18FDG-PET with bone scintigraphy in detecting bone metastasis in breast cancer patients.

Methods

Forty-four women aged 35 to 81 years (mean, 56 years) with breast cancer were examined in this study. Both18FDG-PET and bone scintigraphy were performed for each patient with 0-69 day intervals (mean, 11.5 days). The results of each image interpretation were compared retrospectively. Whole-body bones were classified into 9 anatomical regions. Metastases were confirmed at 45/187 regions in 14 patients by bone biopsy or clinical follow-up including other imaging techniques for a period of at least 6 months afterwards.

Results

On a region basis, the sensitivity, specificity, and accuracy of18FDG-PET were 84%, 99% and 95%, respectively. Although these results were comparable to those of bone scintigraphy, the combination of18FDG-PET and bone scintigraphy improved the sensitivity (98%) and accuracy (97%) of detection. False negative lesions of bone scintigraphy were mostly bone marrow metastases and those of18FDG-PET were mostly osteoblastic metastases.18FDG-PET was superior to bone scintigraphy in the detection of osteolytic lesions (92% vs. 73%), but inferior in the detection of osteoblastic lesions (74% vs. 95%).

Conclusions

This study shows that18FDG-PET tends to be superior to bone scintigraphy in the detection of osteolytic lesions, but inferior in the detection of osteoblastic lesions.18FDG-PET should play a complementary role in detecting bone metastasis with bone scintigraphy.

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Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan

    Koichiro Abe, Yasuo Kuwabara, Hirofumi Koga, Shingo Baba, Kazutaka Hayashi, Naoki Takahashi & Hiroshi Honda

  2. Department of Health Sciences, School of Medicine, Kyushu University, Japan

    Masayuki Sasaki

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  1. Koichiro Abe
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  2. Masayuki Sasaki
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  3. Yasuo Kuwabara
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  4. Hirofumi Koga
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  5. Shingo Baba
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  6. Kazutaka Hayashi
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  7. Naoki Takahashi
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  8. Hiroshi Honda
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Correspondence to Koichiro Abe.

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Abe, K., Sasaki, M., Kuwabara, Y. et al. Comparison of18FDG-PET with99mTc-HMDP scntigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med 19, 573–579 (2005). https://doi.org/10.1007/BF02985050

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  • DOI: https://doi.org/10.1007/BF02985050

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