F-18 DEOXYGLUCOSE POSITRON-EMISSION-TOMOGRAPHY FOR THE DETECTION OF BONE METASTASES IN PATIENTS WITH NONSMALL CELL LUNG-CANCER

Despite advances in morphological imaging, some patients with lung can cer are found to have non resectable disease at surgery or die of recu rrence within a year of surgery. At present, metastatic bone involveme nt is usually assessed using bone scintigraphy, which has a high sensi tivity but a poor specificity. We have attempted to evaluate the utili ty of the fluorine-18 deoxyglucose positron emission tomography (FDG P ET) for the detection of bone metastasis. One hundred and ten consecut ive patients with histological diagnosis of non-small cell lung cancer (NSCLC) who underwent both FDG PET and bone scintigraphy were selecte d for this review. In this group, there were 43 patients with metastat ic disease (stage IV). Among these, 21 (19% of total group) had one or several bone metastases confirmed by biopsy (n = 8) or radiographic t echniques (n = 13). Radionuclide bone scanning correctly identified 54 out of 89 cases without osseous involvement and 19 out of 21 osseous involvements. On the other hand, FDG PET correctly identified the abse nce of osseous involvement in 87 out of 89 patients and the presence o f bone metastasis in 19 out of 21 patients. Thus using PET there were two false-negative and two false-positive cases. PET and bone scanning had, respectively, an accuracy of 96% and 66% in the evaluation of os seous involvement in patients with NSCLC. In conclusion, our data sugg est that whole-body FDG PET may be useful in detecting bone metastases in patients with known NSCLC.