Efficacy comparison between (18)F-FDG PET/CT and bone scintigraphy in detecting bony metastases of non-small-cell lung cancer.
BACKGROUND
We compared the efficacies of integrated whole-body (18)F-FDG PET/CT (PET/CT) and (99m)Tc-DPD bone scintigraphy (bone scan) for the detection of bone metastases in patients with non-small-cell lung cancer (NSCLC).


METHODS
Between April 2004 and May 2007, the database at our institution was retrospectively reviewed to identify all patients with newly diagnosed NSCLC and who underwent staging with both PET/CT and bone scan prior to the initiation of therapy. Presence of bone metastases was confirmed by considering all available clinical information. This search identified 1000 patients, 265 women and 735 men (age range, 18-89 years; median age, 65 years).


RESULTS
Bone metastases were confirmed in 105 (10.5%) patients. The respective accuracy, sensitivity, and specificity of PET/CT and bone scan in detecting bone metastases were 98.3% and 95.1% (p<0.001), 94.3% and 78.1% (p=0.001), and 98.8% and 97.4% (p=0.006). PET/CT also showed lower incidence of false positive (1.2% vs. 2.9%) and false-negative results (5.7% vs. 21.9%) than bone scan. Agreement between PET/CT and bone scan findings was good with calculated kappa=0.732.


CONCLUSIONS
PET/CT was superior to bone scan in the detection of bone metastases of NSCLC with the lower incidence of false-positive as well as false-negative results.
Song
Jin Woo
JW
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Seoul, South Korea.
Oh
Yeon-Mock
YM
Shim
Tae-Sun
TS
Kim
Woo Sung
WS
Ryu
Jin-Sook
JS
Choi
Chang-Min
CM
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000556:secondary; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D012189:Retrospective Studies
D019788:Fluorodeoxyglucose F18