title: Performance of 18F-fluoride PET or PET/CT for the detection of bone metastases: a meta-analysis.
abstract: OBJECTIVE
  This study aimed to evaluate the diagnostic accuracy of F-fluoride PET or PET/CT compared with Tc-MDP bone scintigraphy and F-FDG PET/CT in the detection of bone metastases.
  
  
  METHODS
  An electronic search was conducted using PubMed/MEDLINE and EMBASE. The methodological quality of the included studies was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. All analyses were performed on Stata version 12.0 and Meta-DiSc version 1.4.
  
  
  RESULTS
  Twenty articles containing 1170 patients were identified. On a patient basis, the pooled sensitivity, specificity, and the area under the summary receiver operating characteristic curve of F-fluoride PET or PET/CT were 92% (95% confidence interval [CI], 89%-95%), 93% (95% CI, 91%-95%), and 0.985, respectively. On a lesion basis, the pooled sensitivity, specificity, and area under the summary receiver operating characteristic curve of F-fluoride PET or PET/CT were 87% (95% CI, 85%-88%), 95% (95% CI, 94%-96%), and 0.979, respectively. When compared with Tc-MDP bone scintigraphy, F-fluoride PET or PET/CT showed both higher sensitivity (96% vs. 88%, P = 0.002) and specificity (91% vs. 80%, P = 0.001). When compared with F-FDG PET/CT, F-fluoride PET/CT showed higher sensitivity (94% vs. 73%, P = 0.003), whereas no significant difference was observed in specificity (88% vs. 98%, P = 0.06).
  
  
  CONCLUSIONS
  F-fluoride PET or PET/CT has an excellent diagnostic capacity for the detection of bone metastases and shows advantages when compared with Tc-MDP bone scintigraphy and F-FDG PET/CT.
authors.affiliation: From the Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
authors.forename: Chen-Tian
authors.initials: CT
authors.lastname: Shen
authors.forename: Zhong-Ling
authors.initials: ZL
authors.lastname: Qiu
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Han
authors.forename: Quan-Yong
authors.initials: QY
authors.lastname: Luo
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D005260:Female; D005459:Fluorides; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D005459:Fluorides