Detection of bone metastases in non-small cell lung cancer patients: comparison of whole-body diffusion-weighted imaging (DWI), whole-body MR imaging without and with DWI, whole-body FDG-PET/CT, and bone scintigraphy.
OBJECTIVE
To prospectively compare the capability for bone metastasis assessment of whole-body diffusion-weighted imaging (DWI), magnetic resonance imaging (MRI) without and with DWI, [(18)F] fluoro-2-D-glucose positron emission tomography with computed tomography (FDG-PET/CT) and bone scintigraphy in non-small cell carcinoma (NSCLC) patients.


METHODS
In all, 115 consecutive NSCLC patients (66 men, 49 women; mean age 72 years) prospectively underwent whole-body MRI, PET/CT, and bone scintigraphy before treatment. For each method, probability of metastasis was independently assessed by using a 5-point visual scoring system on a per-site basis. Receiver operating characteristic (ROC)-based positive tests were used to determine the practical threshold value for each method on a per-site basis. Sensitivities, specificities, and accuracies were then compared on a per-site and per-patient basis by means of McNemar's test.


RESULTS
When the practical threshold values were adapted, specificity and accuracy of whole-body MRI with DWI were significantly higher than those of bone scintigraphy and PET/CT (P < 0.05). On a per-patient basis, specificity and accuracy of whole-body MRI with DWI were significantly higher than those of bone scintigraphy (P < 0.05).


CONCLUSIONS
Whole-body MRI with DWI can be used for bone metastasis assessment of NSCLC patients as accurate as bone scintigraphy and/or PET/CT.
Takenaka
Daisuke
D
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
Ohno
Yoshiharu
Y
Matsumoto
Keiko
K
Aoyama
Nobukazu
N
Onishi
Yumiko
Y
Koyama
Hisanobu
H
Nogami
Munenobu
M
Yoshikawa
Takeshi
T
Matsumoto
Sumiaki
S
Sugimura
Kazuro
K
D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000556:secondary*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005682:Gadolinium; D006571:Heterocyclic Compounds; D049671:History, 18th Century; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods*
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C062402:gadoteridol; D019788:Fluorodeoxyglucose F18; D005682:Gadolinium