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Comparison of diagnostic ability between 99mTc-MDP bone scan and 18F-FDG PET/CT for bone metastasis in patients with small cell lung cancer

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Abstract

Objective

The aim of this study was to compare the diagnostic ability of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) with that of 99mTc-methylene diphosphonate (99mTc-MDP) bone scan for bone metastasis in staging patients with small cell lung cancer (SCLC).

Methods

Ninety-five patients with SCLC who underwent both 18F-FDG PET/CT and 99mTc-MDP bone scan for initial staging work-up were retrospectively enrolled. All 18F-FDG PET/CT and bone scan images were visually assessed. Bone metastasis was confirmed by histopathological results and all available clinical information.

Results

Of 95 patients with SCLC, metastatic bone lesions were found in 30 patients, and 84 metastatic lesions were evaluated on a lesion-basis analysis. The sensitivity of 18F-FDG PET/CT was 100 % on a per-patient basis and 87 % on a per-lesion basis, and there was no false-positive lesion on PET/CT images. In contrast, the sensitivity of the bone scan was 37 % on a per-patient basis and 29 % on a per-lesion basis. The bone scan showed 11 false-positive lesions. The bone scan detected two metastatic lesions that were not detected by PET/CT, which were outside the region scanned by PET/CT. On follow-up bone scan, 21 lesions that were not detected by the initial bone scan but were detected by PET/CT were newly detected.

Conclusions

In patients with SCLC, 18F-FDG PET/CT showed higher detection rate of bone metastasis than 99mTc-MDP bone scan. Thus, 18F-FDG PET/CT can replace bone scan in staging patients with SCLC.

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Conflict of interest

No potential conflicts of interest were disclosed.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Jeju National University Hospital, Jeju, Korea

    Jeong Won Lee

  2. Department of Nuclear Medicine, Soonchunhyang University Hospital, 23-20, Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do, 330-721, Korea

    Sang Mi Lee

  3. Department of Internal Medicine, Soonchunhyang University Hospital, Cheonan, Korea

    Ho Sung Lee & Yong Hoon Kim

  4. Department of Radiology, Soonchunhyang University Hospital, Cheonan, Korea

    Won Kyoung Bae

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  1. Jeong Won Lee
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  2. Sang Mi Lee
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Correspondence to Sang Mi Lee.

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Lee, J.W., Lee, S.M., Lee, H.S. et al. Comparison of diagnostic ability between 99mTc-MDP bone scan and 18F-FDG PET/CT for bone metastasis in patients with small cell lung cancer. Ann Nucl Med 26, 627–633 (2012). https://doi.org/10.1007/s12149-012-0622-3

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  • DOI: https://doi.org/10.1007/s12149-012-0622-3

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