A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and 99mTc-MDP whole-body bone scanning for imaging osteolytic bone metastases

Abstract

BackgroundThe objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 99mTc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.MethodsThirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and 99mTc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.ResultsThe sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6–96.2%), 83.3% (95% CI, 43.6–96.9%), and 94.2% (95% CI, 91.5–96.1%), respectively. It was found that 99mTc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4–55.1%) sensitivity, 50.0% (95% CI, 18.8–81.2%) specificity, and 50.2% (95% CI, 45.5–55.1%) accuracy. 18F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001).ConclusionsF-FDG PET/CT has a higher diagnostic value than 99mTc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

Comparison of 18F-NaF PET/CT and 18F-FDG PET/CT for Detection of Skull-Base Invasion and Osseous Metastases in Nasopharyngeal Carcinoma

“…99m Tc-methylene diphosphonate (MDP) planar bone scan or single-photon emission computed tomography (SPECT) is widely used as noninvasive methods for detecting osseous metastases. However, these methods cannot obtain cross-sectional images of all the lesions, and they have lower resolution than other imaging techniques, such as positron emission tomography/computed tomography (PET/CT) [ 5 ].…”

Invasion of Adjacent Lumbar Vertebral Body from Renal Pelvis Carcinoma: Associated With Bone Metastasis But Easily Overlooked on Initial CT Scan

“…L1 and L2 vertebral body invasion are osteolytic lesions and can be identified from CT scan rather than from bone scan. 18 F-FDG PET/CT has a higher diagnostic value than whole-body 99m Tc-MDP bone scan for the detection of osteolytic bone metastases, especially in the vertebrae (12,13). PET/CT scans used in this study to detect the tumor extent only showed one case positive for bone metastasis.…”

Mandibular metastasis of cholangiocarcinoma: A case report

“… 8 Bone scans are of considerable utility in detecting areas of osteoblastic activity in areas affected by trauma, infection, and arthropathy, 17 but may not detect metastatic tumors that are primarily associated with bone destruction and minimal or no osteoblastic activity. 17 18 In contrast, PET/CT has been found to show higher sensitivity than bone scans in the detection of osteolytic metastatic tumors, but lower sensitivity in detecting osteoblastic bony lesions. 19 We can therefore speculate that the bone scan did not detect mandibular metastasis, whereas the PET/CT scan showed mild hypermetabolism because our patient experienced osteolytic bone destruction in the right mandible.…”