Prospective Evaluation of the Clinical Value of Planar Bone Scans, SPECT, and 18F-Labeled NaF PET in Newly Diagnosed Lung Cancer

Journal of Nuclear Medicine

Sven N. Reske¹  Jürgen Hetzel¹  Karin Nüssle¹  Andreas K. Buck¹  Holger Schirrmeister¹  Gerhard Glatting¹  Kerstin Dziuk¹  Martin Hetzel¹  Andreas Gabelmann¹  Coskun Arslandemir¹ 

[1] Departments of Nuclear Medicine, Internal Medicine, and Diagnostic Radiology, University of Ulm, Ulm, Germany Departments of Nuclear Medicine, Internal Medicine, and Diagnostic Radiology, University of Ulm, Ulm, Germany Departments of Nuclear Medicine, Internal Medicine, and Diagnostic Radiology, University of Ulm, Ulm, Germany

关键词: lung cancer;    bone metastases;    PET;    SPECT;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Previous studies have shown that vertebral bone metastases (BM) not seen on planar bone scintigraphy (BS) might be present on 18F-fluoride PET scans or at MRI. Therefore, we evaluated the effect of SPECT or 18F-labeled NaF PET (18F PET) imaging on the management of patients with newly diagnosed lung cancer. Methods: Fifty-three patients with small cell lung cancer or locally advanced non–small cell lung cancer were prospectively examined with planar BS, SPECT of the vertebral column, and 18F PET. MRI and all available imaging methods, as well as the clinical course, were used as reference methods. BS with and without SPECT and 18F PET were compared using a 5-point scale for receiver operating characteristic (ROC) curve analysis. Results: Twelve patients had BM. BS produced 6 false-negatives, SPECT produced 1 false-negative, and 18F PET produced no false-negatives. The area under the ROC curve was 0.779 for BS, 0.944 for SPECT, and 0.993 for 18F PET. The areas under the ROC curve of 18F PET and BS complemented by SPECT were not significantly different, and both tomographic methods were significantly more accurate than planar BS. As a result of SPECT or 18F PET imaging, clinical management was changed in 5 patients (9%) or 6 patients (11%), respectively. Conclusion: As indicated by the area under the ROC curve analysis, 18F PET is the most accurate whole-body imaging modality for screening for BM. Routinely performed SPECT imaging is practicable, is cost-effective, and improves the accuracy of BS.

【 授权许可】

Unknown