Objective: The aim of this study was to compare the diagnostic ability of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) with that of (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) bone scan for bone metastasis in staging patients with small cell lung cancer (SCLC).
Methods: Ninety-five patients with SCLC who underwent both (18)F-FDG PET/CT and (99m)Tc-MDP bone scan for initial staging work-up were retrospectively enrolled. All (18)F-FDG PET/CT and bone scan images were visually assessed. Bone metastasis was confirmed by histopathological results and all available clinical information.
Results: Of 95 patients with SCLC, metastatic bone lesions were found in 30 patients, and 84 metastatic lesions were evaluated on a lesion-basis analysis. The sensitivity of (18)F-FDG PET/CT was 100 % on a per-patient basis and 87 % on a per-lesion basis, and there was no false-positive lesion on PET/CT images. In contrast, the sensitivity of the bone scan was 37 % on a per-patient basis and 29 % on a per-lesion basis. The bone scan showed 11 false-positive lesions. The bone scan detected two metastatic lesions that were not detected by PET/CT, which were outside the region scanned by PET/CT. On follow-up bone scan, 21 lesions that were not detected by the initial bone scan but were detected by PET/CT were newly detected.
Conclusions: In patients with SCLC, (18)F-FDG PET/CT showed higher detection rate of bone metastasis than (99m)Tc-MDP bone scan. Thus, (18)F-FDG PET/CT can replace bone scan in staging patients with SCLC.