A Comparative Research About 18F-fdg Pet/Ct And 99mTc-MDP Bone Scintigraphy In Detecting Skeletal Metastases From Lung Cancer

Backgrounds and ObjectiveThe early diagnosis of skeletal metastases in lung cancer is crucial, because it is directly related to clinical phases, treatment plans, complications of skeletal metastases, life quality of patients and survival times. Our study is to investigate the usage and differences of 18F-FDG PET/CT and 99mTc-MDP bone scan in detecting skeletal metastases from lung cancer.Materials and MethodsWe analyzed the patients suffering lung cancer from October 2010 to October 2011 in the first affiliated hospital of Zhengzhou university and all the patients were confirmed to be lung cancer by pathology and underwent both 18F-FDG PET/CT and 99mTc-MDP bone scan.86 cases were collected, including 56 male cases and 30 female cases; ages were from 32 to 88 years old,56.8±13.49 years old on average. There were 33 cases of adenocarcinoma,15 cases of squamous carcinoma and 5 cases of small cell carcinoma. All the patients were confirmed suffering lung cancer and had the examinations before their treatment procedures. The standards to decide skeletal metastases were pathology, MRI and confirmed by half year’s follow-up with PET/CT or bone scintigraphy.We analyzed the data from our experiment with chi-square test and McNemar test by SPSS 17.0.Result78 cases were confirmed to be lung cancer with skeletal metastases in all the patients, including 53 male cases and 25 female cases. In all the patients with skeletal metastases,66.6% was adenocarcinoma,29.5% was squamous cell carcinoma.27 cases were single metastases,51 cases were multiple metastases. The locations of skeletal metastases were chest(51 cases,65.4%),vertebral column(39 cases,50.0%) and pelvis(23 cases,29.5%).In all the patients, PET/CT and bone scintigraphy detected 389 lesions of skeleton in total,360 lesions were found by PET/CT,204 lesions were found by 99mTc-MDP bone scan,195 lesions were found by both examinations.325 lesions were finally confirmed to be skeletal metastases,64 lesions were found to be benign ones.301 skeletal metastases were detected by PET/CT,173 bone metastases were found by bone scintigraphy, the sensitivities were 92.6% and 53.2% respectively;59 benign bone lesions were found by PET/CT,31 benign lesions were detected by whole body bone scan, the specificities were 92.2% and 48.4% respectively; the accuracy of PET/CT and bone scintigraphy in detecting skeletal metastases were 92.5% and 52.4% respectively. All the differences in diagnostic sensitivity, specificity and accuracy between the two examinations had statistic significances(P< 0.05). Conclusions18F-FDG PET/CT and 99mTc-MDP bone scan were all useful examinations in detecting skeletal metastases from lung cancer.The diagnostic sensitivity, specificity and accuracy of PET/CT were all higher than that of bone scintigraphy.