title: Detection of vertebral metastases: a meta-analysis comparing MRI, CT, PET, BS and BS with SPECT.
abstract: OBJECTIVE
  To perform a meta-analysis to compare the diagnostic value of magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), bone scintigraphy (BS) and BS with single-photon emission computed tomography (SPECT) in detecting vertebral metastases.
  
  
  METHODS
  Relevant original articles published from January 1995 to December 2015 were searched. Two reviewers independently extracted data. Software called "META-DiSc" was used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) curves.
  
  
  RESULTS
  Twenty-three articles consisting of 33 studies fulfilled all inclusion criteria. On per-patient basis, for sensitivity, MRI = PET = SPECT > CT = BS ("=" indicated no significant difference, P > 0.05; ">" indicated significantly higher, P < 0.05). For specificity, MRI = CT = BS > SPECT > PET. For DOR, MRI > SPECT > BS > CT = PET. SROC curves for SPECT and MRI showed better diagnostic accuracy than others. On per-lesion basis, for sensitivity, PET = SPECT = MRI > BS > CT. For specificity, MRI = CT > PET = SPECT = BS. For DOR, MRI > SPECT > CT = PET > BS. SROC curves showed MRI had the best while CT had the lowest diagnostic accuracy.
  
  
  CONCLUSIONS
  For diagnosis of vertebral metastases, MRI was found to be the best modality and also better than other techniques on both per-patient and per-lesion basis.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
authors.forename: Shenghao
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Meng
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Orthopaedic Institute, Medical College, Soochow University, Suzhou, China.
authors.forename: Fan
authors.initials: F
authors.lastname: He
authors.affiliation: Department of Orthopaedic Surgery, Haimen People's Hospital, Haimen, China.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China. szyhlspine@163.com.|Orthopaedic Institute, Medical College, Soochow University, Suzhou, China. szyhlspine@163.com.
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D009362:Neoplasm Metastasis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: BS; MRI; Meta-analysis; PET; Vertebral metastases