title: Diagnostic performance of (18)F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis.
abstract: BACKGROUND
  We prospectively compared the diagnostic accuracies of PET/CT and BS in patients with suspected bone metastases from breast cancer.
  
  
  METHODS
  This single-institution prospective study included consecutive patients with suspected bone metastases from biopsy-proven breast cancer seen at Tokai University Hospital between September 2011 and March 2014. Inclusion criteria included suspicions for bone metastases (bone pain, elevated alkaline phosphatase, elevated tumor markers, or suspected bone metastases by BS). Two nuclear medicine physicians evaluated PET/CT and BS images.
  
  
  RESULTS
  Thirty patients were initially enrolled in this study. Two were excluded from the analyses because they declined to undergo imaging during follow-up. PET/CT successfully detected bone metastases in all 10 patients finally diagnosed with the condition, whereas BS identified 2. The two methods were not highly concordant in detecting osseous metastases. In 19 of 28 paired studies (68 %), 2 (10 %) were positive for metastasis, and 17 (90 %) were negative. Nine occurrences (32 %) were discordant; of these, 2 were PET/CT positive and BS negative; 5 were PET/CT positive and BS equivocal; one was PET/CT negative and BS equivocal, and one was PET/CT equivocal and BS negative.
  
  
  CONCLUSIONS
  Our results indicated that PET/CT was superior to BS for the diagnosis of bone metastases. On the basis of the results of previous studies as well as ours, PET/CT could replace BS as the initial modality to detect bone metastases in patients suspected for the condition.
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. niikura@is.icc.u-tokai.ac.jp.|Department of Target Therapy Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan. niikura@is.icc.u-tokai.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.affiliation: Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hashimoto
authors.affiliation: Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kazama
authors.affiliation: Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Koizumi
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Rin
authors.initials: R
authors.lastname: Ogiya
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Mayako
authors.initials: M
authors.lastname: Terao
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Oshitanai
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Morioka
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Banri
authors.initials: B
authors.lastname: Tsuda
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Takuho
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Target Therapy Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Iwaisako
authors.affiliation: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iwamoto
authors.affiliation: Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.affiliation: Department of Diagnostic Radiology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011446:Prospective Studies; D011877:Radionuclide Imaging / Q000379:methods*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Bone metastases; Bone scintigraphy; Breast cancer; PET/CT