Comparison of (18)F-FDG-PET/CT with (99m)Tc-MDP bone scintigraphy for the detection of bone metastases in cancer patients

Abstract

Purpose: We tried to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) ((18)F-FDG-PET/CT) scan in detecting bone metastases in cancer patients and to compare the results with bone scan (BS) findings.

Materials and methods: Seventy patients with a variety of neoplastic diseases, who had undergone both (18)F-FDG-PET/CT and BS and were eventually diagnosed as having metastatic bone disease, were enrolled in this study. The confirmation of the final diagnosis of bone metastasis was made by histopathological findings or clinical follow-up for 11 months, on average, including magnetic resonance imaging, (18)F-FDG-PET/CT or BS findings, showing progression of the lesions or their disappearance after therapy.

Results: (18)F-FDG-PET/CT imaging detected bone involvement in 68 out of 70 patients with a sensitivity of 97.1%. In contrast, BS showed the presence of metastases in 60 patients (85.7%). PET/CT detected 666 out of 721 metastatic lesions correctly (92.3%), whereas BS detected 506 lesions totally (70.1%). PET/CT revealed organ metastases in 24 patients and in seven patients with unknown primary; PET/CT also depicted primary tumor.

Conclusion: (18)F-FDG-PET/CT is more sensitive than BS in detecting bone metastasis in patients with neoplastic diseases. (18)F-FDG-PET/CT has the advantage of detecting unknown primary cancers and visceral metastases besides bone metastases.