The objective of this study was to evaluate the feasibility and diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and (99m)Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.
Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent (18)F-FDG PET/CT and (99m)Tc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.
The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6-96.2%), 83.3% (95% CI, 43.6-96.9%), and 94.2% (95% CI, 91.5-96.1%), respectively. It was found that (99m)Tc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4-55.1%) sensitivity, 50.0% (95% CI, 18.8-81.2%) specificity, and 50.2% (95% CI, 45.5-55.1%) accuracy. (18)F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001).
F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.