| Objective: The aim of this study was to compare the diagnostic accuracy of 99mTc-MDP-planar bone scintigraphy(99mTc-MDP-WBS), 18F-fluorodeoxyglucos(FDG) PET/CT and 18F-fluoride(Na F) PET/CT for the detection of bone metastases from lung cancer Methods : Eighty-four patients with lung cancer with suspected bone metastases from lung cancer were retrospectively analysed. All patients were examined with 99mTc-MDP-WBS, 18F-FDG-PET/CT and 18F-Na F-PET/CT, with a maximum interval of 2 weeks between scans. Bone metastases were verified either by pathological results or CT or MRI or follow-up more than six months. The diagnostic accuracy of 99mTc-MDP-WBS, 18F-FDG-PET/CT and 18F-Na F-PET/CT were investigated and compared. The Mc Nemar’s test was used to compare the diagnostic ability of 99mTc-MDP-WBS, 18F-FDG-PET/CT and 18F-Na F-PET/CT. All analyses were performed with SPSS19.0 and P value<0.05 was considered statistically significant. Results: Out of the 84 patients with 409 lesions, 43 with 357 lesions were diagnosed as being true positive for bone metastases from lung cancer. In patient-based analysis, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 99mTc-MDP-WBS were 79.07, 87.80, 87.18, 80.00 and 83.33%, respectively; those of 18F-FDG-PET/CT were 97.67, 92.68, 93.33, 97.44 and 95.23%, and those of18F-Na F-PET/CT were 100.00,97.56, 97.73, 100.00 and 98.81%, respectively. In lesion-based analysis, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 99mTc-MDP-WBS were 84.31, 75.00, 95.85, 41.21 and 83.12%, respectively; those of 18F-FDG-PET/CT were 93.84, 92.31, 98.80, 66.27 and 83.82%, and those of 18F-Na F-PET/CT were 97.76, 88.46, 98.31, 85.19 and 95.84%, respectively. Comparing the diagnostic ability using the Mc Nemar test, both 18F-FDG-PET/CT and 18F-Na F-PET/CT were found to be superior to 99mTc-MDP-WBS for the detection of bone metastases from lung cancer in patient-based and lesion-based analyses(P<0.05). CONCLUSION: In patients with lung cancer,18F-Na F-PET/CT and 18F-FDG-PET/CT showed higher detection rate of bone metastasis than 99mTc-MDP bone scan. 18F-Na F PET/CT is an important method in the diagnosis of bone metastasis of lung cancer. |
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