Skip to main content

Advertisement

Log in

Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma?

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

Bone metastasis occurs frequently in nasopharyngeal carcinoma (NPC) patients. The aim of this study was to compare the clinical value of 18F-FDG PET/CT with that of 99mTc-MDP planar bone scintigraphy (PBS) for detecting bone metastasis in NPC patients.

Methods

Thirty-five histologically proven NPC patients were enrolled in this retrospective study. They underwent both 18F-FDG PET/CT and PBS within 7 days in our department. In a lesion-based analysis, the skeletal system, excluding the head, was divided into four regions: the spine, the pelvis, the thorax, and the appendix. Bone metastasis was considered to be present by either biopsy or clinical follow-up for at least 6 months. PET/CT and PBS were compared by McNemar’s paired-sample test.

Results

A total of 50 lesions were confirmed to be malignant (spine 27, thorax 11, pelvis 8 and appendix 4). Although PET/CT was found to be more sensitive on lesion level than PBS (sensitivity 70.0 versus 42.0 %; P = 0.044), there were still 14 metastatic (28.0 %) lesions that could be detected by PBS while negative in PET/CT imaging. In a patient-based analysis, fifteen (42.9 %) of 35 eligible patients were found to have bone metastasis. The sensitivity, specificity and accuracy of PET/CT was 60.0 % (9/15), 100 % (20/20) and 82.9 % (29/35); as for PBS, it was 66.7 % (10/15), 85.0 % (17/20) and 77.1 % (27/35), respectively. There was no statistical difference between PET/CT and PBS (P > 0.05).

Conclusions

PBS, as a conventional imaging, should be used as an important complement for detecting bone metastasis in NPC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  2. Chiesa F, De Paoli F. Distant metastases from nasopharyngeal cancer. ORL J Otorhinolaryngol Relat Spec. 2001;63:214–6.

    Article  CAS  PubMed  Google Scholar 

  3. Algra PR, Bloem JL, Tissing H, Falke TH, Arndt JW, Verboom LJ. Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics. 1991;11:219–32.

    Article  CAS  PubMed  Google Scholar 

  4. Iagaru A, Young P, Mittra E, Dick DW, Herfkens R, Gambhir SS. Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases. Clin Nucl Med. 2013;38:e290–6.

    Article  PubMed  Google Scholar 

  5. Czernin J, Weber WA, Herschman HR. Molecular imaging in the development of cancer therapeutics. Annu Rev Med. 2006;57:99–118.

    Article  CAS  PubMed  Google Scholar 

  6. Jager PL, de Korte MA, Lub-de Hooge MN, van Waarde A, Koopmans KP, Perik PJ, et al. Molecular imaging: what can be used today. Cancer Imaging. 2005;5:S27–32.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Liu T, Cheng T, Xu W, Yan WL, Liu J, Yang HL. A meta-analysis of 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer. Skeletal Radiol. 2011;40:523–31.

    Article  PubMed  Google Scholar 

  8. Liu T, Xu JY, Xu W, Bai YR, Yan WL, Yang HL. Fluorine-18 deoxyglucose positron emission tomography, magnetic resonance imaging and bone scintigraphy for the diagnosis of bone metastases in patients with lung cancer: which one is the best?–a meta-analysis. Clin Oncol (R Coll Radiol). 2011;23:350–8.

    Article  Google Scholar 

  9. Chang MC, Chen JH, Liang JA, Lin CC, Yang KT, Cheng KY, et al. Meta-analysis: comparison of F-18 fluorodeoxyglucose-positron emission tomography and bone scintigraphy in the detection of bone metastasis in patients with lung cancer. Acad Radiol. 2012;19:349–57.

    Article  PubMed  Google Scholar 

  10. Liu FY, Chang JT, Wang HM, Liao CT, Kang CJ, Ng SH, et al. [18F]fluorodeoxyglucose positron emission tomography is more sensitive than skeletal scintigraphy for detecting bone metastasis in endemic nasopharyngeal carcinoma at initial staging. J Clin Oncol. 2006;24:599–604.

    Article  PubMed  Google Scholar 

  11. Drieskens O, Oyen R, Van Poppel H, Vankan Y, Flamen P, Mortelmans L. FDG-PET for preoperative staging of bladder cancer. Eur J Nucl Med Mol Imaging. 2005;32:1412–7.

    Article  CAS  PubMed  Google Scholar 

  12. Apolo AB, Riches J, Schöder H, Akin O, Trout A, Milowsky MI, et al. Clinical value of fluorine-18 2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in bladder cancer. J Clin Oncol. 2010;28:3973–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Yang Z, Pan L, Cheng J, Hu S, Xu J, Ye D, et al. Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer. Int J Urol. 2012;19:639–44.

    Article  CAS  PubMed  Google Scholar 

  14. Weissleder R. Molecular imaging in cancer. Science. 2006;312:1168–71.

    Article  CAS  PubMed  Google Scholar 

  15. Hoffman JM, Gambhir SS. Molecular imaging the vision and opportunity for radiology in the future. Radiology. 2007;244:39–47.

    Article  PubMed  Google Scholar 

  16. Roodman GD. Mechanisms of bone metastasis. N Engl J Med. 2004;350:1655–64.

    Article  CAS  PubMed  Google Scholar 

  17. Liu NB, Zhu L, Li MH, Sun XR, Hu M, Huo ZW, et al. Diagnostic value of 18F-FDG PET/CT in comparison to bone scintigraphy, CT and 18F-FDG PET for the detection of bone metastasis. Asian Pac J Cancer Prev. 2013;14:3647–52.

    Article  PubMed  Google Scholar 

  18. Micheau C, Boussen H, Klijanienko J, Cvitkovic E, Stosic S, Schwaab G, et al. Bone marrow biopsies in patients with undifferentiated carcinoma of the nasopharyngeal type. Cancer. 1987;60:2459–64.

    Article  CAS  PubMed  Google Scholar 

  19. Sham JS, Cheung YK, Chan FL, Choy D. Nasopharyngeal carcinoma: pattern of skeletal metastases. Br J Radiol. 1990;63:202–5.

    Article  CAS  PubMed  Google Scholar 

  20. Chakraborty D, Bhattacharya A, Mete UK, Mittal BR. Comparison of 18F fluoride PET/CT and 99mTc-MDP bone scan in the detection of skeletal metastases in urinary bladder carcinoma. Clin Nucl Med. 2013;38:616–21.

    Article  PubMed  Google Scholar 

  21. Zhang Y, Shi H, Cheng D, Jiang L, Xiu Y, Li B, et al. Added value of SPECT/spiral CT versus SPECT in diagnosing solitary spinal lesions in patients with extraskeletal malignancies. Nucl Med Commun. 2013;34:451–8.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

No conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Duanshu Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yang, Z., Zhang, Y., Shi, W. et al. Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma?. Ann Nucl Med 28, 411–416 (2014). https://doi.org/10.1007/s12149-014-0831-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-014-0831-z

Keywords

Navigation