Comparative Study Of ¹⁸F-NaF PET/CT And ¹⁸F-FDG PET/CT For Detection Of Bone Metastases From Lung Cancer

Background In 2018,the latest data released by the national cancer center,lung cancer incidence and mortality among the top of the cancer,lung cancer incidence of concealment,may have found a distant metastases,bone is advanced lung cancer is one of the major blood vessels-parts.Early detection and timely treatment of bone metastases in patients with lung cancer clinical stage and prognosis is of great importance.Objective The aim of this study was to compare and analyze the diagnostic value of¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT for the detection of bone metastases from lung cancer.The diagnostic ability of the two methods for different types of bone metastases in lung cancer was quantitatively analyzed.Methods Retrospective analysis was performed on 40 patients diagnosed by pathology with lung cancer and clinically suspected of bone metastasis.¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT were performed within one week,respectively.The diagnostic efficacy of the two methods for bone metastasis of lung cancer was compared by ROC,and the ROC curve was drawn and the area under the curve was compared.The SUVmax values of all lesions with increased metabolism in the two methods were recorded respectively,and the differences between benign and malignant bone lesions,osteolytic and osteogenic metastases in the¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT imaging methods were compared and analyzed.Results（1）A total of 321 abnormal lesions were detected in 40 patients with bone metastases of lung cancer,among which 245 were confirmed as bone metastases and 76 were benign lesions.Comparison of the diagnostic efficacy of ¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT for bone metastasis of lung cancer based on the number of lesions.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the two methods were 93.06%,76.31%,92.68%,77.33%,89.10%,and 91.02%,96.05%,98.67%,76.84%,92.21%,respectively.The diagnostic efficacy of ¹⁸F-FDG PET/CT was higher than that of ¹⁸F-NaF PET/CT（P=0.0026<0.05）.（2）In ¹⁸F-FDG PET imaging,the SUVmax value of bone metastases was higher than that of benign lesions（6.7（4.4,10.8）and 5.2±2.3）,respectively,but the difference was not statistically significant（P=0.158>0.05）.In ¹⁸F-NaF PET imaging,the SUVmax value of bone metastases was significantly higher than that of benign lesions,and the SUVmax value was 20.8（13.2,30.7）and 13.9（11.3,20.15）,respectively,with statistical significance（P<0.001）.（3）¹⁸F-FDG PET/CT has a high detection rate of osteolytic metastases;The detection rate of ¹⁸F-NaF PET/CT for osteogenic metastases was higher,and the difference was not statistically significant（P>0.05）.The SUVmax values of LBM and BBM in ¹⁸F-FDG PET/CT imaging were 8.5（5.5,11.8）and 4.9（2.5,7.9）,respectively.The SUVmax values of LBM and BBM in ¹⁸F-NaF PET/CT imaging were20.8（14.6,42.1）and 22.8（14.0,30.7）,respectively.The metabolic level of LBM was higher in¹⁸F-FDG imaging（P<0.001）.The metabolic level of BBM was higher in ¹⁸F-NaF imaging,and the difference was not statistically significant（P=0.611）.Conclusion（1）Both ¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT have high sensitivity and specificity for the diagnosis of bone metastases from lung cancer;（2）Both ¹⁸F-NaF PET/CT and ¹⁸F-FDG PET/CT have good ability to detect different types of bone metastases.（3）SUVmax is helpful in differentiating bone metastases from benign lesions,and there are differences in the metabolic characteristics of different types of bone metastases.Osteolytic metastases show higher metabolic levels in ¹⁸F-FDG imaging,while osteogenic metastases show higher metabolic levels in ¹⁸F-NaF imaging.