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The aim of this study is to assess the diagnostic accuracy of 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in comparison to 99mTc-MDP bone scan with the aid of single photon emission tomography/ computed tomography (SPECT/CT) in detecting bone metastases.
Bone is a fertile soil for dissemination of metastatic tumor cells which can cause either osteolytic ( destructive) or osteoblastic (sclerotic) or mixed lesions in advanced cancer. Bone metastases are most common throughout the axial skeleton, this leads to major complications referred to as skeletal-related events (SREs), the most frequently are the need for radiotherapy and pathological fractures, associated with increase life morbidity and decrease overall survival.
Seeking accurate image modalities provides definite staging, determining the optimal strategy of treatment and precise evaluation to decrease the burden of complication. Bone scintigraphy has a sensitivity of (78%) with the advantage of widespread availability, low cost and scanning of the entire skeleton in one procedure. The major drawback is the low specificity (48%). SPECT improves the ability of precise localization of abnormal radionuclide uptake and has a specificity (91%), but limited by absence of absolute quantification values as other nuclear medicine imaging modalities. SPECT/CT significantly improves the specificity and positive predictive value of bone scintigraphy in cancer patients.
PET/CT is superior than 2-dimensional planar providing a better image quality and enables quantitation of tumor metabolism. Acquisition and fusion of PET with CT also allow for localization and morphologic evaluation of abnormalities, leading to increased specificity. The National Comprehensive Cancer Network (NCCN) guideline recommended PET/CT imaging in cancers with high risk skeletal metastases, PET has advantage than CT in diagnosing osteolytic lesions; but combining PET with CT, increase the detection of osteoblastic lesions.
This study will recruit patients diagnosed with different types of tumors and referred to nuclear medicine unit to perform 18F-FDG PET/CT resulted in diagnosed or suspected to have bone metastases, these patients will be referred to undergo 99Tc-MDP bone scan.
Not yet recruiting
Published on BioPortfolio: 2019-09-12T02:34:42-0400
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