title: Comparison between whole-body positron emission tomography and bone scintigraphy in evaluating bony metastases of esophageal carcinomas.
abstract: BACKGROUND
  Positron emission tomography (PET) with 18-F-fluorodeoxyglucose (FDG) has already proved useful in assessing the extension of esophageal carcinomas, detecting tumor recurrence and monitoring responses to therapy. This study aimed to elucidate the potential role of FDG-PET compared with technetium-99m methylene diphosphonate (Tc-99m MDP) bone scintigraphy in the evaluation of bony metastasis in esophageal carcinoma patients.
  
  
  METHODS
  Forty-four patients with thoracic esophageal carcinomas, who underwent FDG-PET together with bone scintigraphy within 1 month between January 2000 and September 2003, were included in this study.
  
  
  RESULTS
  Of the 44 patients, 13 had 31 bone metastases and, of these, 6 were diagnosed pretreatment and 7 had recurrence after esophagectomy surgery. Of the 31 metastases, 9 were in the vertebral column, 11 in the thoracic cage (including the ribs, clavicle, sternum and scapula), 9 in the pelvic bones and 2 in the long bones of the extremities. In evaluating the detection of bony metastasis, FDG-PET showed 92% sensitivity, 94% specificity and 93% accuracy, compared with 77%, 84% and 82%o, respectively, for bone scintigraphy. Although the sensitivity, specificity and accuracy of PET were slightly higher than those of bone scintigraphy, these differences were not statistically significant according to the McNemar's test. Three patients with false-negative findings on their bone scans had positive findings with PET; all of these lesions were osteolytic metastases.
  
  
  CONCLUSIONS
  FDG-PET scans were superior to bone scintigraphy in detecting bony metastases of esophageal carcinomas. Therefore, FDG-PET can be used for the detection and follow-up of bone tumors when Tc-99m MDP bone scintigraphy gives negative findings.
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan. hiroyuki@po.wind.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Junko
authors.initials: J
authors.lastname: Takita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Ahmad
authors.initials: A
authors.lastname: Faried
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukai
authors.forename: Norihiro
authors.initials: N
authors.lastname: Masuda
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Ryokuhei
authors.initials: R
authors.lastname: Manda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ojima
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.forename: Noboru
authors.initials: N
authors.lastname: Oriuchi
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate