title: The value of bone marrow scintigraphy using 99mTc monoclonal antigranulocyte antibodies in complement to bone scintigraphy in detecting bone metastases from primary breast cancer.
abstract: This prospective study evaluates bone marrow scintigraphy (BMS) in detecting bone metastases from primary breast cancer when performed in complement to conventional bone scan (BS). Sixty women predominantly with low-stage disease underwent BS followed by BMS within 1-35 days using BW250/183 antigranulocyte antibodies. A receiver operating characteristic (ROC) analysis was performed to compare BS to BS+BMS on a patient-by-patient basis using a 'gold standard' composed of subsequent computed tomography, magnetic resonance imaging, X-ray or BS examinations and at least a 12 month follow-up. Metastases were present in eight out of 60 patients (13%). Specificity was improved by BS+BMS compared to BS alone (90%, 65%) as well as positive predictive value (62%, 27%), accuracy (87%, 72%), positive (10.4, 2.4) and negative (0.20, 0.00) likelihood ratios. Sensitivity (100%, 88%) and negative predictive value (100%, 97%) were similar for BMS+BS and BS alone. As a result of BMS, clinical management was modified in 15 patients (25%). In conclusion, BMS supplements BS by improving specificity, positive predictive value and accuracy in detecting breast cancer bone metastases. The ROC curves show improved specificity for BS+BMS at the same sensitivity compared to BS alone. Consequently, BMS may be useful in low-stage subjects with positive or equivocal BS for metastases.
authors.affiliation: Division of Nuclear Medicine, Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. John.Prior@chuv.hospvd.ch
authors.forename: J O
authors.initials: JO
authors.lastname: Prior
authors.forename: G
authors.initials: G
authors.lastname: Barghouth
authors.forename: J F
authors.initials: JF
authors.lastname: Delaloye
authors.forename: S
authors.initials: S
authors.lastname: Leyvraz
authors.forename: A
authors.initials: A
authors.lastname: Bischof Delaloye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D001853:Bone Marrow / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011786:Quality Control; D012372:ROC Curve; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014915:Whole-Body Counting
chemical_list: D000911:Antibodies, Monoclonal; C104213:BW 250 183; D019275:Radiopharmaceuticals