title: Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma?
abstract: OBJECTIVE
  Bone metastasis occurs frequently in nasopharyngeal carcinoma (NPC) patients. The aim of this study was to compare the clinical value of 18F-FDG PET/CT with that of 99mTc-MDP planar bone scintigraphy (PBS) for detecting bone metastasis in NPC patients.
  
  
  METHODS
  Thirty-five histologically proven NPC patients were enrolled in this retrospective study. They underwent both 18F-FDG PET/CT and PBS within 7 days in our department. In a lesion-based analysis, the skeletal system, excluding the head, was divided into four regions: the spine, the pelvis, the thorax, and the appendix. Bone metastasis was considered to be present by either biopsy or clinical follow-up for at least 6 months. PET/CT and PBS were compared by McNemar's paired-sample test.
  
  
  RESULTS
  A total of 50 lesions were confirmed to be malignant (spine 27, thorax 11, pelvis 8 and appendix 4). Although PET/CT was found to be more sensitive on lesion level than PBS (sensitivity 70.0 versus 42.0%; P=0.044), there were still 14 metastatic (28.0%) lesions that could be detected by PBS while negative in PET/CT imaging. In a patient-based analysis, fifteen (42.9%) of 35 eligible patients were found to have bone metastasis. The sensitivity, specificity and accuracy of PET/CT was 60.0% (9/15), 100% (20/20) and 82.9% (29/35); as for PBS, it was 66.7% (10/15), 85.0% (17/20) and 77.1% (27/35), respectively. There was no statistical difference between PET/CT and PBS (P>0.05).
  
  
  CONCLUSIONS
  PBS, as a conventional imaging, should be used as an important complement for detecting bone metastasis in NPC patients.
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Zhongyi
authors.initials: Z
authors.lastname: Yang
authors.forename: Yongping
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Beiling
authors.initials: B
authors.lastname: Zhu
authors.forename: Silong
authors.initials: S
authors.lastname: Hu
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Yao
authors.forename: Herong
authors.initials: H
authors.lastname: Pan
authors.forename: Chaosu
authors.initials: C
authors.lastname: Hu
authors.forename: Yingjian
authors.initials: Y
authors.lastname: Zhang
authors.forename: Duanshu
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D002277:Carcinoma; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D049268:Positron-Emission Tomography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate