Does PET/CT Have an Additional Value in Detection of Osteolytic Bone Metastases
Abstract
Introduction:
Although radionuclide bone scanning with technetium 99m (99mTc) methyl diphosphonate has been the standard means of evaluating individuals suspected of having bone metastases, 18F-FDG PET may be comparable in accuracy, depending on the tumor type. 18F-FDG PET has been reported as being appropriate for detecting bone metastases specially lytic and mixed lesions. More recently, integrated PET/computed tomography (CT) has revealed various implications for evaluating bone metastases.
Aim of the study:
To evaluate the sensitivity, positive predictive value (PPV) of 18F-FDG PET/ (CT) in the identification of malignant bone lesions when the PET and CT findings are concordant and discordant.
Patients and Methods:
Fifty four patients (25 female and 29 male patients; age range, 10–74 years) with 158 PET/CT detected bone lesions were included in this study. The sensitivity, PPVs of the integrated PET/CT and of each modality, CT and PET components of the examination were calculated.
Results:
Of the 82 bone lesions with positive findings at both PET and CT, 73 bone lesions were malignant and 9 were benign lesions with sensitivity 100% and PPV of 89%. Of the 36 bone lesions with positive findings at PET
and negative findings at CT, 25 were malignant and 11 were benign bone lesions with sensitivity of 46.2% and PPV of 69.4%. Of 40 bone lesions with negative findings at PET and positive findings at CT, 29 were malignant and 11 were benign bone lesions with sensitivity of 53.7% & PPV of 72.5%.
Conclusions:
PET/CT has high sensitivity & PPV for detection of bone metastases than either PET or CT as a separate modalities. FDG PET has high sensitivity & PPV in lytic lesions than the sclerotic ones.
Although radionuclide bone scanning with technetium 99m (99mTc) methyl diphosphonate has been the standard means of evaluating individuals suspected of having bone metastases, 18F-FDG PET may be comparable in accuracy, depending on the tumor type. 18F-FDG PET has been reported as being appropriate for detecting bone metastases specially lytic and mixed lesions. More recently, integrated PET/computed tomography (CT) has revealed various implications for evaluating bone metastases.
Aim of the study:
To evaluate the sensitivity, positive predictive value (PPV) of 18F-FDG PET/ (CT) in the identification of malignant bone lesions when the PET and CT findings are concordant and discordant.
Patients and Methods:
Fifty four patients (25 female and 29 male patients; age range, 10–74 years) with 158 PET/CT detected bone lesions were included in this study. The sensitivity, PPVs of the integrated PET/CT and of each modality, CT and PET components of the examination were calculated.
Results:
Of the 82 bone lesions with positive findings at both PET and CT, 73 bone lesions were malignant and 9 were benign lesions with sensitivity 100% and PPV of 89%. Of the 36 bone lesions with positive findings at PET
and negative findings at CT, 25 were malignant and 11 were benign bone lesions with sensitivity of 46.2% and PPV of 69.4%. Of 40 bone lesions with negative findings at PET and positive findings at CT, 29 were malignant and 11 were benign bone lesions with sensitivity of 53.7% & PPV of 72.5%.
Conclusions:
PET/CT has high sensitivity & PPV for detection of bone metastases than either PET or CT as a separate modalities. FDG PET has high sensitivity & PPV in lytic lesions than the sclerotic ones.