The comparision of tc99m-mdp whole body bone scintigraphy with fdg-pet tumor scanning images in the detection of metastatic bone lesions

FDG-PET which has an important place in oncology and getting wide spread, is an imaging method. In this study we aimed to evaluate the detection of bone metastases and the comparision of accuracy, sensitivity and spesificity with FDG-PET and conventional bone scintigraphy technics. In this study, between February 2006-February 2007 forty-one patients with malignancy who received both PET and Tc99m-Methylenediphosphonat (Tc99m-MDP) with bone scintigraphy within one month were retrospectively analyzed in the Nuclear Medicine Department of Gaziantep University Faculty of Medicine. Twenty-three of patients were females and eighteen of them were males; age range 39-84, mean age 58.4±10.2 years old. These patients were 17 breast cancers (%41), 16 lung cancers (%39), 2 unknown primary tumors (%5), 2 prostate cancers (%5), 1 laryngeal cancer (%2.5), 1 renal cancer (%2.5), 1 esophageal cancer (%2.5) and 1 multiple myeloma (%2.5). All patient were examined with whole body PET scanner with two slices entegrated Siemens Biograph 2 PET/CT. The whole body bone scintigraphy imagings of 34 (%83) patients were performed in our department with Philips Forte Dual Head Gamma Camera using low energy-high resolution collimators (LERH) and the whole body bone scintigraphy imagings of 7 (%17) patients were outside. In the detection of bone metastases with FDG-PET/CT while the accuracy was %85.2, sensivity was %86.9, spesificity was %82.3, in the bone scintigraphy accuracy was %82.5, sensivity was %90.5, spesificity was %69.4. Just like this, in the bone metastases of breast and lung cancers, the accuracy and the specificity of PET/CT were found higher than the bone scintigraphy. In the detection of osteolytic and osteosclerotic metastases no difference was found between two studies but in osteolytic lesions mean SUVmax was higher than osteosclerotic lesions. As a result, in the detection of bone metastases while the accuracitity and spesificity of FDG-PET/CT was higher than bone scintigraphy, the sensivity of bone scintigraphy was higher than PET/CT. At last, it was convinced that it would be more useful to use both studies as the complemantary of each other.