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Detection of bone metastases in patients with lung cancer: 99mTc-MDP planar bone scintigraphy, 18F-fluoride PET or 18F-FDG PET/CT
European Journal of Nuclear Medicine & Molecular Imaging, 06/11/09

Krüger S et al. - In a study to compare diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) PET/CT vs standard planar bone scintigraphy (BS) and 18F-labelled NaF (18F) PET for detection of bone metastases (BM) in non-small cell lung cancer (NSCLC), it was concluded that integrated 18F-FDG PET/CT is superior to BS in detection of osteolytic BM in NSCLC. PET/CT may obviate the need to perform additional BS or 18F PET in staging of NSCLC, which significantly reduces costs.

• 18F-FDG PET/CT was performed in 126 pts with NSCLC.
• Within 7 days BS (n=58) or 18F PET (n=68) was performed.
• 18F-FDG PET/CT, BS and 18F PET were evaluated by 2 experienced readers.
• Lesions were graded on a scale from 1 (definite BM) to 5 (degenerative lesion), and equivocal lesions were determined as indifferent (grade 3).

• 92 pts showed degenerative lesions (grade 4/5) on PET/CT, BS or 18F PET.
• In 34 pts (27%), BM lesions were diagnosed (grades 1 and 2).
• In 13 of 18 pts, BM were concordantly diagnosed with PET/CT and 18F PET.
• PET/CT showed more BM vs 18F PET (53 vs 40).
• In 1 pt, 1 osteolytic BM was false-negative on 18F PET.
• 18F PET identified 4 pts with BM compared with negative findings on PET/CT.
• Of 16 pts, 11 had concordant findings of BM on PET/CT and BS.
• In 3 pts, BS was false-negative and in 2 pts BM were diagnosed as indifferent.

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