Discordant findings in patients with non-small-cell lung cancer: absolutely normal bone scans versus disseminated bone metastases on positron-emission tomography/computed tomography

Ak, İlknur; Sivrikoz, Muammer Cumhur; Entok, Emre; Vardareli̇, Erkan

doi:10.1016/j.ejcts.2009.11.011

Cited by 30 publications

(14 citation statements)

References 20 publications

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“…After the development of PET and PET/CT, however, it has been shown that PET and PET/CT are superior in the detection of osteolytic bone metastases [15,17]. This has been studied mainly in non small cell lung carcinoma, a disease in which bone metastases are usually osteolytic [26,27]. In breast cancer, due to the combination of osteolytic and sclerotic bone metastases, bone scintigraphy may remain of added value [28].…”

Section: Discussionmentioning

confidence: 96%

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques

Koolen

Peeters

Aukema

et al. 2011

Breast Cancer Res Treat

128

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The aim of the present study was to investigate if 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) outperforms conventional imaging techniques for excluding distant metastases prior to neoadjuvant chemotherapy (NAC) treatment in patients with stage II and III breast cancer. Second, we assessed the clinical importance of false positive findings. One hundred and fifty four patients with stage II or III breast cancer, scheduled to receive NAC, underwent an 18F-FDG PET/CT scan and conventional imaging, consisting of bone scintigraphy, ultrasound of the liver, and chest radiography. Suspect additional lesions at staging examination were confirmed by biopsy and histopathology and/or additional imaging. Metastases that were detected within 6 months after the PET/CT scan were considered evidence of occult metastasis, missed by staging examination. Forty-two additional distant lesions were seen in 25 patients with PET/CT and could be confirmed in 20 (13%) of 154 patients. PET/CT was false positive for 8 additional lesions (19%) and misclassified the presence of metastatic disease in 5 (3%) of 154 patients. In 16 (80%) of 20 patients, additional lesions were exclusively seen with PET/CT, leading to a change in treatment in 13 (8%) of 154 patients. In 129 patients with a negative staging PET/CT, no metastases developed during the follow-up of 9.0 months. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in the detection of additional distant lesions in patients with stage II or III breast cancer are 100, 96, 80, 100, and 97%, respectively. FDG PET/CT is superior to conventional imaging techniques in the detection of distant metastases in patients with untreated stage II or III breast cancer and is associated with a low false positive rate. PET/CT may be of additional value in the staging of breast cancer prior to NAC.

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Section: Discussionmentioning

confidence: 96%

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques

Koolen

Peeters

Aukema

et al. 2011

Breast Cancer Res Treat

128

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“…14,15 Sclerotic metastases are relatively acellular with lower volume of tumour tissues and less bone destruction than lytic lesions. 16,17 The sensitivity of lesion detection by the radiology resident was 57.7% on patient-based analysis through original CT reading. The reason for such low sensitivity was that the inexperienced radiologist often missed patients with single metastatic bone lesion on CT, especially when the lesion was small and sclerotic.…”

Section: Discussionmentioning

confidence: 99%

Effect of Bone Reading CT software on radiologist performance in detecting bone metastases from breast cancer

Jeon

Bae

et al. 2017

BJR

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In patients with breast cancer, the use of Bone Reading application improved radiologist performance in bone metastasis detection compared with original chest CT reading with reduced reading time. This software will be more helpful to inexperienced radiologists for improving the reading performance. Advances in knowledge: Small and sclerotic lesions can be easily missed in original CT reading. Using Bone Reading CT software can enhance the performance of radiologists in detecting bone metastasis in breast cancer. False-negative rates can be significantly reduced in both inexperienced and experienced readers.

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“…62 Results of 99m Tc MDP and FDG PET/CT for bone involvement have been shown to be discordant in up to 20% of patients with lung cancer, primarily because 99m Tc MDP cannot identify early metastatic bone marrow infiltration. 64 Although uptake of FDG in bone can occur on PET studies before radiologically evident bone destruction, inflammatory conditions can also cause focal uptake. For this reason, biopsy or correlation with anatomic imaging studies is mandated to confirm an osseous metastasis before choosing a treatment regimen, if it is the sole abnormality.…”

Section: Metastasismentioning

confidence: 99%

Staging of Lung Cancer

Groot

Carter

Cuellar

et al. 2015

Clinics in Chest Medicine

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Discordant findings in patients with non-small-cell lung cancer: absolutely normal bone scans versus disseminated bone metastases on positron-emission tomography/computed tomography

Cited by 30 publications

References 20 publications

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques

Effect of Bone Reading CT software on radiologist performance in detecting bone metastases from breast cancer

Staging of Lung Cancer

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