title: A meta-analysis of (18)F-Fluoride positron emission tomography for assessment of metastatic bone tumor.
abstract: OBJECTIVE
  The aim of this study was to assess the diagnostic performance of (18)F-Fluoride positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) compared with bone scintigraphy (BS) planar or BS planar and single photon emission computed tomography (SPECT) in evaluating patients with metastatic bone tumor.
  
  
  METHODS
  We performed a meta-analysis of all available studies addressing the diagnostic accuracy of (18)F-Fluoride PET, (18)F-Fluoride PET/CT, BS planar, and BS planar and SPECT for detecting the metastatic bone tumor. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and drew summary receiver operating characteristic curves using hierarchical regression models. We also compared the effective dose and cost-effectiveness estimated by data from the enrolled studies between (18)F-Fluoride PET or PET/CT and BS planar or BS planar and SPECT.
  
  
  RESULTS
  When comparing all studies with data on (18)F-Fluoride PET or PET/CT, sensitivity and specificity were 96.2% [95% confidence interval (CI) 93.5-98.9%] and 98.5% (95% CI 97.0-100%), respectively, on a patient basis and 96.9% (95% CI 95.9-98.0%) and 98.0% (95% CI 97.1-98.9%), respectively, on a lesion basis. The Az values of (18)F-Fluoride PET or PET/CT were 0.986 for the patient basis and 0.905 for the lesion basis, whereas those of BS or BS and SPECT were 0.866 for the patient basis and 0.854 for the lesion basis. However, the estimated effective dose and average cost-effective ratio were poorer for (18)F-Fluoride PET or PET/CT than those of BS planar or BS planar and SPECT.
  
  
  CONCLUSIONS
  (18)F-Fluoride PET or PET/CT has excellent diagnostic performance for the detection of metastatic bone tumor, but the estimated effective dose and average cost-effective ratio are at a disadvantage compared with BS planar or BS planar and SPECT.
authors.affiliation: Department of Radiology, Yokohama City University Graduate School of Medicine, Kanazawa-ku, Kanagawa, Japan. utateish@yokohama-cu.ac.jp
authors.forename: Ukihide
authors.initials: U
authors.lastname: Tateishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.forename: Kazuya
authors.initials: K
authors.lastname: Shizukuishi
authors.forename: Ryogo
authors.initials: R
authors.lastname: Minamimoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murano
authors.forename: Takashi
authors.initials: T
authors.lastname: Terauchi
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
authors.forename: E Edmund
authors.initials: EE
authors.lastname: Kim
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D005459:Fluorides; D005462:Fluorine Radioisotopes; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D005462:Fluorine Radioisotopes; D005459:Fluorides