Title:A Lesion based and Sub-regional Comparison of FDG PET/CT and MDP Bone Scintigraphy in Detection of Bone Metastasis in Breast Cancer
Volume: 13
Author(s): Selin S. Demir*, Gul E. Aktas and Fusun U. Yenici
Affiliation:
- Department Faculty of Medicine, Department of Nuclear Medicine, Trakya University, 22030, Edirne,Turkey
Keywords:
FDG, PET/CT, imaging, bone scintigraphy, breast cancer, bone metastases.
Abstract: Background: The aim of this study was to compare sensitivity, specificity and accuracy
of 18F-FDG PET/CT and bone scintigraphy (BS) in detection of bone metastases in breast cancer
patients; particularly according to anatomical regions, CT characteristics, tumor markers and hormone
receptor status.
Methods: Fifty patients, who received both FDG PET/CT and BS were retrospectively analyzed.
Patients’ information including age, histological tumor type, hormone receptor positivity, c-erb B-2
oncogenes, tumor markers, clinical stages and subsequent clinical courses were reviewed. Lesion
by lesion, regional and overall analyses was performed. The extent of metastases was assessed with
twelve regions segmented bone scan index (BSI). The final diagnosis was established by histopathology,
imaging and follow-up.
Results: Overall sensitivity, specificity and accuracy were 83.2%, 100% and 87.6% for PET/CT,
and 69.8%, 76.1% and 71.5% for BS. PET/CT was found to be more sensitive, specific and accurate
for all regions, except cranium. While PET/CT was more sensitive in detecting osteolytic lesions,
BS was more sensitive in detecting osteoblastic lesions. CA 15-3 levels were correlated with
number of metastases for both techniques (P<0.05). Although PET/CT detected more metastatic
lesions, the number of lesions detected with both techniques and the calculated BSI’s were not
significantly different (p= 0.061, p= 0.053, respectively). BSI and number of totally detected metastases
with both techniques were correlated with the final assessment.
Conclusion: The sensitivity, specificity and accuracy of PET/CT in detecting overall and subregional
bone lesions were significantly higher. Although PET/CT detected more metastatic lesions,
both techniques seemed to supply complementary information to each other.
