Skeletal Radiology

, Volume 43, Issue 11, pp 1503–1513 | Cite as

Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis

Review Article

Abstract

Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95 % confidence interval (CI): 0.83–0.96], 0.97 (95 % CI: 0.91–0.99), 0.79 (95 % CI: 0.73–0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95 % CI: 0.93–1.00), 0.95 (95 % CI: 0.90–0.97), and 0.82 (95 % CI: 0.78–0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95 % CI: 0.81–0.87), 0.90 (95 % CI: 0.86–0.93), 0.59 (95 % CI: 0.55–0.63), respectively. The pooled specificities were 0.93 (95 % CI: 0.89–0.96) for choline PET/CT, 0.85 (95 % CI: 0.80–0.90) for bone SPECT, and 0.75 (95 % CI: 0.71–0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer.

Keywords

Bone metastases Prostate cancer Positron emission tomography with computed tomography MRI Bone scintigraphy SPECT Meta-analysis 

Notes

Acknowledgments

This study was supported by the National Natural Science Foundation (Grant Nos., 81271532, 81171456, and 30900378).

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© ISS 2014

Authors and Affiliations

  • Guohua Shen
    • 1
  • Houfu Deng
    • 1
  • Shuang Hu
    • 1
  • Zhiyun Jia
    • 1
  1. 1.Department of Nuclear MedicineWest China Hospital of Sichuan UniversityChengduPeople’s Republic of China

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