title: Comparison of 18F-FDG PET/CT with bone scintigraphy for detection of bone metastasis: a meta-analysis.
abstract: BACKGROUND
  The skeleton is one of the favorable sites for the metastasis of almost all human malignant neoplasms. An accurate diagnosis of bone metastasis is crucial for the patient's staging and management.
  
  
  OBJECTIVE
  To investigate and compare diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and bone scintigraphy (BS) for detection of bone metastasis in malignancies using meta-analysis.
  
  
  METHODS
  PubMed (Medline included) was searched for relevant articles. We assessed the methodological quality with Quality Assessment of Diagnosis Accuracy Studies (QUADAS) score tool, and used statistical software to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curve.
  
  
  RESULTS
  Six studies met inclusion criteria. For 18F-FDG PET/CT, the pooled sensitivity and specificity were 0.934 and 0.975, respectively. The pooled positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR) were 34.990, 0.068 and 559.02, respectively. The area under the SROC curve was 0.9854. For BS, the pooled sensitivity, specificity, LR + , LR- and DOR were 0.706 (0.642-0.764), 0.911 (0.896-0.926), 13.982 (2.419-80.817), 0.319 (0.143-0.712), and 60.420 (21.393-170.64), respectively. The area under the SROC curve was 0.9386.
  
  
  CONCLUSIONS
  The results indicate that 18F-FDG PET/CT do have both higher sensitivity and specificity than bone scintigraphy for detecting metastatic bone tumor. However, further research is needed to evaluate the diagnostic performance of 18F-FDG PET/CT and BS in each common malignancy.
authors.affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Cheng
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Li
authors.forename: Zhaoqiang
authors.initials: Z
authors.lastname: Xu
authors.forename: Lihua
authors.initials: L
authors.lastname: Bao
authors.forename: Dianfu
authors.initials: D
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18