Is 18 F-FDG PET/CT more reliable than 99m Tc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal
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ORIGINAL ARTICLE
Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma? Zhongyi Yang • Yongping Zhang • Wei Shi • Beiling Zhu • Silong Hu • Zhifeng Yao • Herong Pan • Chaosu Hu • Yingjian Zhang • Duanshu Li
Received: 11 December 2013 / Accepted: 19 February 2014 / Published online: 8 March 2014 Ó The Japanese Society of Nuclear Medicine 2014
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 Z. Yang Y. Zhang W. Shi B. Zhu S. Hu Z. Yao H. Pan Y. Zhang Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China Z. Yang Y. Zhang W. Shi B. Zhu S. Hu Z. Yao H. Pan C. Hu Y. Zhang D. Li Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China C. Hu Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China D. Li (&) Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, Xuhui District, Shanghai, China e-mail: [email protected]
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. Keywords 18F-FDG PET/CT 99mTc-MDP planar bone scintigraphy Bone metastasis Nasopharyngeal carcinoma
Introduction Nasopharyngeal carcinoma (NPC) is an epithelial malignancy, distinct from other squamous cell carcinomas of the head and neck. It is etiologically associated with the Epstein–Barr virus, and shows an endemic distribution:incidence rates are highest in South-Eastern Asia, including Malaysia, Indonesia, Singapore a
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