title: Is there any significance of lung cancer histology to compare the diagnostic accuracies of (18)F-FDG-PET/CT and (99m)Tc-MDP BS for the detection of bone metastases in advanced NSCLC?
abstract: OBJECTIVE
  Bone scintigraphy (BS) and fluorine-18 deoxyglucose positron emission tomography computed tomography ((18)F-FDG-PET/CT) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in histological subgroups of non-small cell lung cancer (NSCLC) remains ambiguous. The aim of this study was to compare the efficacy of (18)F-FDG-PET/C and 99mTc-methylene diphosphonate ((99m)Tc-MDP) BS in the detection of bone metastases of patients in NSCLC. Specifically, we compared the diagnostic accuracies of these imaging techniques evaluating bone metastasis in histological subgroups of NSCLC.
  
  
  METHODS
  Fifty-three patients with advanced NSCLC, who had undergone both (18)F-FDG-PET/CT and BS and were eventually diagnosed as having bone metastasis, were enrolled in this retrospective study.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of (18)F-FDG-PET/CT and BS were 90.4%, 99.4%, 98.1%, 96.6%, 97.0% and 84.6%, 93.1%, 82.5%, 93.2, 90.8%, respectively. The κ statistics were calculated for (18)F-FDG-PET/CT and BS. The κ-value was 0.67 between (18)F-FDG-PET/CT and BS in all patients. On the other hand, the κ-value was 0.65 in adenocarcinoma, and 0.61 in squamous cell carcinoma between (18)F-FDG-PET/CT and BS. The κ-values suggested excellent agreement between all patients and histological subgroups of NSCLC.
  
  
  CONCLUSIONS
  (18)F-FDG-PET/CT was more favorable than BS in the screening of metastatic bone lesions, but the trend did not reach statistical significance in all patients and histological subgroups of NSCLC. Our results need to be validated in prospective and larger study clinical trials to further clarify this topic.
authors: Department of Medical Oncology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors: Ali
authors: A
authors: Inal
authors: Department of Medical Oncology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors: Muhammed Ali
authors: MA
authors: Kaplan
authors: Department of Medical Oncology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors: Mehmet
authors: M
authors: Kucukoner
authors: Department of Medical Oncology, School of Medicine, Dicle University, Diyarbakir, Turkey.
authors: Zuhat
authors: Z
authors: Urakcı
authors: Department of Nuclear Medicine, Dicle University, Diyarbakir, Turkey.
authors: Zeki
authors: Z
authors: Dostbil
authors: DiyarbakIr Numune Education and Research Hospital, DiyarbakIr, Turkey.
authors: Hail
authors: H
authors: Komek
authors: Department of Radiology, Dicle University, Diyarbakir, Turkey.
authors: Hakan
authors: H
authors: Onder
authors: Department of Nuclear Medicine, Dicle University, Diyarbakir, Turkey.
authors: Bekir
authors: B
authors: Tasdemir
authors: Department of Medical Oncology, Dicle University, Diyarbakir, Turkey.
authors: Abdurrahman
authors: A
authors: Isıkdogan
keywords: 18F-FDG-PET/CT; 99mTc- methylene diphosphonate bone scintigraphy; bone metastases; non-small cell lung cancer