Tc-MDP whole-body bone scanning for imaging osteolytic bone metastases

Background: The objective of this study was to evaluate the feasibility and diagnostic value of F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases. Methods: Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent F-FDG PET/CT and Tc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods. Results: The sensitivity, specificity, and accuracy of F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6–96.2%), 83.3% (95% CI, 43.6–96.9%), and 94.2% (95% CI, 91.5–96.1%), respectively. It was found that Tc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4–55.1%) sensitivity, 50.0% (95% CI, 18.8–81.2%) specificity, and 50.2% (95% CI, 45.5–55.1%) accuracy. F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP wholebody BS (p<0.001). Conclusions: F-FDG PET/CT has a higher diagnostic value than Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.