Bone positron emission tomography with or without CT is more accurate than bone scan for detection of bone metastasis

Korean J Radiol. 2013 May-Jun;14(3):510-9. doi: 10.3348/kjr.2013.14.3.510. Epub 2013 May 2.

Abstract

Objective: Na(18)F bone positron emission tomography (bone PET) is a new imaging modality which is useful for the evaluation of bone diseases. Here, we compared the diagnostic accuracies between bone PET and bone scan for the detection of bone metastasis (BM).

Materials and methods: Sixteen cancer patients (M:F = 10:6, mean age = 60 ± 12 years) who underwent both bone PET and bone scan were analyzed. Bone PET was conducted 30 minutes after the injection of 370 MBq Na(18)F, and a bone scan was performed 3 hours after the injection of 1295 MBq (99m)Tc-hydroxymethylene diphosphonate.

Results: In the patient-based analysis (8 patients with BM and 8 without BM), the sensitivities of bone PET (100% = 8/8) and bone scan (87.5% = 7/8) were not significantly different (p > 0.05), whereas the specificity of bone PET (87.5% = 7/8) was significantly greater than that of the bone scan (25% = 2/8) (p < 0.05). In the lesion-based analysis (43 lesions in 14 patients; 31 malignant and 12 benign), the sensitivity of bone PET (100% = 31/31) was significantly greater than that of bone scan (38.7% = 12/31) (p < 0.01), and the specificity of bone PET (75.0% = 9/12) was also significantly higher than that of bone scan (8.3% = 1/12) (p < 0.05). The receiver operating characteristic curve analysis showed that bone PET was significantly more accurate than the bone scan in the patient (p = 0.0306) and lesion (p = 0.0001) based analyses.

Conclusion: Na(18)F bone PET is more accurate than bone scan for BM evaluation.

Keywords: 99mTc-HDP; Bone metastasis; Bone scan; Na18F; Positron emission tomography; Positron emission tomography/computed tomography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / secondary*
  • Diphosphonates
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging / methods
  • Organotechnetium Compounds
  • Positron-Emission Tomography / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sodium
  • Tomography, X-Ray Computed / methods

Substances

  • Diphosphonates
  • Fluorine Radioisotopes
  • Organotechnetium Compounds
  • technetium Tc 99m dihydroxymethylene diphosphonic acid
  • Fluorodeoxyglucose F18
  • Sodium