Meta-analysis. Comparison of F-18 Fluorodeoxyglucose-Positron Emission Tomography and Bone Scintigraphy in the Detection of Bone Metastasis in Patients with Lung Cancer

Ming Che Chang, Jin Hua Chen, Ji An Liang, Cheng Chieh Lin, Kuang Tao Yang, Kai Yuan Cheng, Jun Jun Yeh, Chia Hung Kao

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Rationale and Objectives: The aim of this review was to evaluate the diagnostic properties of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (CT) and bone scintigraphy in the detection of osseous metastases in patients with lung cancer. Materials and Methods: MEDLINE was searched for relevant original articles published between January 1995 and August 2010. Inclusion criteria were as follows: FDG-PET or PET/CT and bone scintigraphy was carried out to detect bone metastases in patients with lung cancer, sufficient data were presented to construct a 2 × 2 contingency table, and histopathologic analysis and/or close clinical and imaging follow-up and/or radiographic confirmation by multiple imaging modalities was used as the reference standard. Two reviewers independently extracted data related to research design, sample size, imaging techniques, technical characteristics, reference standards, methods of imaging interpretation, and totals of true-positives, false-positives, true-negatives, and false-negatives. Stata was used to obtain per patient and per lesion pooled estimates of sensitivity, specificity, and positive and negative likelihood ratios, and areas under summary receiver-operating characteristic curves (AUCs) were calculated. Results: The pooled patient-based sensitivity of FDG-PET or PET/CT was 0.93 (95% confidence interval [CI], 0.88-0.96), specificity was 0.95 (95% CI, 0.91-0.98), and the AUC was 0.94. The pooled sensitivity of bone scans was 0.87 (95% CI, 0.79-0.93), specificity was0.82(95% CI, 0.62-0.92), and the AUC was 0.91. The pooled lesion-based sensitivity of FDG-PET or PET/CT was 0.93 (95% CI, 0.84-0.97), specificity was 0.91 (95% CI, 0.80-0.96), and the AUC was 0.97. The pooled sensitivity of bone scans was 0.92 (95% CI, 0.87-0.95), specificity was 0.57 (95% CI, 0.09-0.95), and the AUC was 0.92. Conclusions: Although FDG-PET or PET/CT has higher sensitivity and specificity than bone scintigraphy, further research with a less biased design is needed to determine the most efficacious imaging modality for the detection of metastatic lung cancer.

Original languageEnglish
Pages (from-to)349-357
Number of pages9
JournalAcademic Radiology
Volume19
Issue number3
DOIs
Publication statusPublished - Mar 2012
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Radionuclide Imaging
Positron-Emission Tomography
Meta-Analysis
Lung Neoplasms
Confidence Intervals
Neoplasm Metastasis
Bone and Bones
Area Under Curve
Sensitivity and Specificity
MEDLINE
ROC Curve
Sample Size
Research Design
Positron Emission Tomography Computed Tomography
Research

Keywords

  • Bone metastasis
  • Bone scan
  • Bone scintigraphy
  • FDG-PET
  • Lung cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Meta-analysis. Comparison of F-18 Fluorodeoxyglucose-Positron Emission Tomography and Bone Scintigraphy in the Detection of Bone Metastasis in Patients with Lung Cancer. / Chang, Ming Che; Chen, Jin Hua; Liang, Ji An; Lin, Cheng Chieh; Yang, Kuang Tao; Cheng, Kai Yuan; Yeh, Jun Jun; Kao, Chia Hung.

In: Academic Radiology, Vol. 19, No. 3, 03.2012, p. 349-357.

Research output: Contribution to journalArticle

Chang, Ming Che ; Chen, Jin Hua ; Liang, Ji An ; Lin, Cheng Chieh ; Yang, Kuang Tao ; Cheng, Kai Yuan ; Yeh, Jun Jun ; Kao, Chia Hung. / Meta-analysis. Comparison of F-18 Fluorodeoxyglucose-Positron Emission Tomography and Bone Scintigraphy in the Detection of Bone Metastasis in Patients with Lung Cancer. In: Academic Radiology. 2012 ; Vol. 19, No. 3. pp. 349-357.
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abstract = "Rationale and Objectives: The aim of this review was to evaluate the diagnostic properties of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (CT) and bone scintigraphy in the detection of osseous metastases in patients with lung cancer. Materials and Methods: MEDLINE was searched for relevant original articles published between January 1995 and August 2010. Inclusion criteria were as follows: FDG-PET or PET/CT and bone scintigraphy was carried out to detect bone metastases in patients with lung cancer, sufficient data were presented to construct a 2 × 2 contingency table, and histopathologic analysis and/or close clinical and imaging follow-up and/or radiographic confirmation by multiple imaging modalities was used as the reference standard. Two reviewers independently extracted data related to research design, sample size, imaging techniques, technical characteristics, reference standards, methods of imaging interpretation, and totals of true-positives, false-positives, true-negatives, and false-negatives. Stata was used to obtain per patient and per lesion pooled estimates of sensitivity, specificity, and positive and negative likelihood ratios, and areas under summary receiver-operating characteristic curves (AUCs) were calculated. Results: The pooled patient-based sensitivity of FDG-PET or PET/CT was 0.93 (95{\%} confidence interval [CI], 0.88-0.96), specificity was 0.95 (95{\%} CI, 0.91-0.98), and the AUC was 0.94. The pooled sensitivity of bone scans was 0.87 (95{\%} CI, 0.79-0.93), specificity was0.82(95{\%} CI, 0.62-0.92), and the AUC was 0.91. The pooled lesion-based sensitivity of FDG-PET or PET/CT was 0.93 (95{\%} CI, 0.84-0.97), specificity was 0.91 (95{\%} CI, 0.80-0.96), and the AUC was 0.97. The pooled sensitivity of bone scans was 0.92 (95{\%} CI, 0.87-0.95), specificity was 0.57 (95{\%} CI, 0.09-0.95), and the AUC was 0.92. Conclusions: Although FDG-PET or PET/CT has higher sensitivity and specificity than bone scintigraphy, further research with a less biased design is needed to determine the most efficacious imaging modality for the detection of metastatic lung cancer.",
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AU - Liang, Ji An

AU - Lin, Cheng Chieh

AU - Yang, Kuang Tao

AU - Cheng, Kai Yuan

AU - Yeh, Jun Jun

AU - Kao, Chia Hung

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KW - Bone metastasis

KW - Bone scan

KW - Bone scintigraphy

KW - FDG-PET

KW - Lung cancer

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