A meta-analysis of ¹⁸FDG-PET-CT, ¹⁸FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with lung cancer

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• 作者：Xinhua Qu^a ; ^b ; Xiaolu Huang^c ; Weili Yan^d ; Lianming Wu^e ; Kerong Dai^a ; ^b ; ^{krdai@163.com}
• 关键词：Lung cancer ; Bone metastasis ; Positron emission tomography with computed tomography ; Positron emission tomography ; Magnetic resonance imaging ; Bone scintigraphy ; Meta-analysis
• 刊名：European Journal of Radiology
• 出版年：2012
• 期刊代码：93_0720048x
• 类别：med
• 出版时间：May, 2012
• 卷：81
• 期：5
• 页码：1007-1015
• 文件大小：672 K

摘要

Background and purpose

Lung cancer is the most common cause of cancer related death among both men and women worldwide. The skeleton is the most common site of cancer metastasis. Early detection is crucial for prognosis. To evaluate and compare the capability for bone metastasis assessment of [¹⁸F] fluoro-2-d-glucose positron emission tomography with computed tomography (¹⁸FDG-PET-CT), [¹⁸F] fluoro-2-d-glucose positron emission tomography (¹⁸FDG-PET), magnetic resonance imaging (MRI) and bone scintigraphy (BS) in lung cancer patients, a meta-analysis is preformed.

Methods

We searched MEDLINE, OVID, EMBASE and the Cochrane Library for studies evaluating diagnosis validity of ¹⁸FDG-PET-CT, ¹⁸FDG-PET, MRI and BS between January 1990 and August 2010. Meta-analysis methods were used to pool sensitivity, specificity, diagnostic odd ratios (DORs) and to construct a summary receiver-operating characteristic curve (SROC).

Results

A total of 17 articles (9 ¹⁸FDG-PET-CT studies, 9 ¹⁸FDG-PET studies, 6 MRI studies and 16 BS studies) that included 2940 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for the detection of bone metastasis in lung cancer using ¹⁸FDG-PET-CT, ¹⁸FDG-PET, MRI and BS were 0.92 (95%CI, 0.88-0.95), 0.87 (95%CI, 0.81-0.92), 0.77 (95%CI, 0.65-0.87) and 0.86 (95%CI, 0.82-0.89), respectively. The pooled specificity for the detection of bone metastasis from lung cancer using ¹⁸FDG-PET-CT, ¹⁸FDG-PET, MRI and BS were 0.98 (95%CI, 0.97-0.98), 0.94 (95%CI, 0.92-0.96), 0.92 (95%CI, 0.88-0.95), 0.88 (95%CI, 0.86-0.89), respectively. The pooled DORs estimates for ¹⁸FDG-PET-CT 449.17 were significantly higher than for ¹⁸FDG-PET (118.25, P < 0.001), MRI (38.27, P < 0.001) and BS (63.37, P < 0.001). The pooled sensitivity of BS was not correlated with the prevalence of bone metastasis.

Conclusion

The results showed that both ¹⁸FDG-PET-CT and ¹⁸FDG-PET were better imaging methods for diagnosing bone metastasis from lung cancer than MRI and BS. ¹⁸FDG-PET-CT has higher diagnostic value (sensitivity, specificity and DORs) for diagnosing bone metastasis from lung cancer than any other imaging methods.