Comparison of the diagnosis value of 18 F-FDG PET/CT with 99m Tc-MDP bone scintigraphy or bone scintigraphy com-bined CT in the detection of bone metastases of lung cancer

ZHOU Jianming; MAO Chaoming; ZHU Li; GAO Jianqing; YIM Ruigen; ZHANG Lirong; ZHAO Liang; KOMG Qian-qian; LI Lin

Abstract：Objective To investigate the diagnostic value of 18 F-FDG PET/CT, compared with 99m Tc-MDP bone scintigraphy or combined CT for the detection of bone metastases in patients with lung cancer .Methods We retrospectively analyzed 56 pa-tients (33 men, 23 women, median age 60.0 years).All specimens conrmed by the pathology underwent both 18 F-FDG PET/CT and bone scintigraphy from January 2014 to August 2016 .We combined BS with CT which was used for 18 F-FDG PET/CT and joint pathology and clinical follow-up diagnosis to compare the diagnostic value of bone scintigraphy , or combined CT with 18 F-FDG PET/CT.Chi-square test was used for comparing results of bone metastasis by this three methods .P <0.05 was considered statistically significant.Results Of the 56 patients, 28 patients with 138 metastatic bone lesions were diagnosed .Based on pa-tients, the specificity and accuracy for 18 F-FDG PET/CT (96.4% and 94.6%) and BS combined CT(89.3% and 91.1%) were higher than BS(60.7%and 75.0%) in diagnosisof bone metastases of lung cancer (all P <0.05), but the sensitivity of 18 F-FDG PET/CT(92.9%) and BS(89.3%) had no statistical significance .The difference between 18 F-FDG PET/CT and BS combined CT had no statistical significance .Based on metastatic bone lesions , the relevance ratio of bone metastases by 18 F-FDG PET/CT(92.0%) were higher than BS combined CT (79.0%)(x2 =9.473, P <0.01).Meantime,the relevance ratio of bone metastases by BS combined CT (79.0%) was higher than BS(68.1%)(x2 =4.191, P <0.05).The relevance ratio of no ab-normal morphology ( bone marrow metastases ) and osteolytic metastases by 18 F-FDG PET/CT were higher than BS combined CT(x2 =16.261 and 15.300, P <0.01).The relevance ratio of osteolytic metastases by BS combined CT was higher than BS (x2 =6.711, P <0.01).The relevance ratio of osteoblastic metastases by BS was higher than 18 F-FDG PET/CT (x2 =8.892, P <0.01).We found 18 F-FDG PET/CT was easier to find metastases located in thoracic vertebra ,sacralvertebra,pelvis and femur. Conclusion The diagnostic value of 18 F-FDG PET/CT and BS combined CT was better than BS alone for the detection of bone metastases in patients with lung cancer .18 F-FDG PET/CT could earlierly find bone marrow metastases and small osteolytic metas-tases than BS combined CT .