Sensitivity in detecting osseous lesions depends on anatomic localization: Planar bone scintigraphy versus 18F PET

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Holger Schirrmeister - , Universität Ulm (Autor:in)
  • Albrecht Guhlmann - , Universität Ulm (Autor:in)
  • Klaus Elsner - , Universität Ulm (Autor:in)
  • Jörg Kotzerke - , Universität Ulm (Autor:in)
  • Gerhard Glatting - , Universität Ulm (Autor:in)
  • Marion Rentschler - , Universität Ulm (Autor:in)
  • Bernd Neumaier - , Universität Ulm (Autor:in)
  • Harald Träger - , Universität Ulm (Autor:in)
  • Karin Nüssle - , Universität Ulm (Autor:in)
  • Sven N. Reske - , Universität Ulm (Autor:in)

Abstract

Radionuclide bone scanning (RNB) is considered to be the most practical screening technique for assessing the entire skeleton for skeletal metastases. However, RNB has been shown to be of lower sensitivity than MRI and CT in detecting osteolytic metastases. A prospective study was designed to evaluate the accuracy of planar RNB versus tomographic bone imaging with 18F-labeled NaF and PET (18F PET) in detecting osteolytic and osteoblastic metastases and its dependency on their anatomic localization. Methods: Forty-four patients with known prostate, lung or thyroid carcinoma were examined with both planar RNB and 18F PET. A panel of reference methods including MRI of the spine, 131I scintigraphy, conventional radiography and spiral CT was used as the gold standard. RNB and 18F PET were compared by a lesion-by-lesion analysis using a five-point score for receiver operating characteristic (ROC) curve analysis. Results: 18F PET showed 96 metastases (67 of prostate carcinoma and 29 of lung or thyroid cancer), whereas RNB revealed 46 metastases (33 of prostate carcinoma and 13 of lung or thyroid cancer). All lesions found with RNB were also detected with 18F PET. Compared with 18F PET and the reference methods, RNB had a sensitivity of 82.8% in detecting malignant and benign osseous lesions in the skull, thorax and extremities and a sensitivity of 40% in the spine and pelvis. The area under the ROC curve was 0.99 for 18F PET and 0.64 for RNB. Conclusion: 18F PET is more sensitive than RNB in detecting osseous lesions. With RNB, sensitivity in detecting osseous metastases is highly dependent on anatomic localization of these lesions, whereas detection rates of osteoblastic and osteolytic metastases are similar. Higher detection rates and more accurate differentiation between benign and malignant lesions with 18F PET suggest the use of 18F PET when possible.

Details

OriginalspracheEnglisch
Seiten (von - bis)1623-1629
Seitenumfang7
FachzeitschriftJournal of Nuclear Medicine
Jahrgang40
Ausgabenummer10
PublikationsstatusVeröffentlicht - Okt. 1999
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

PubMed 10520701

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • F PET, Bone metastases, Radionuclide bone scanning