UNLABELLED: As bone metastases might be present in lung cancer despite a normal bone scan, we examined various alternatives prospectively. Positron emission tomography using F-18 sodium fluoride (PET) and single photon emission tomography (SPECT) were more sensitive than a planar bone scan. PET was more accurate with a shorter examination time than SPECT but had higher incremental costs. INTRODUCTION: Previous studies have shown that vertebral bone metastases not seen on planar bone scans may be present on F-18 fluoride positron emission tomography (PET) scan or single photon emission computed tomography (SPECT). The purpose of this study was to measure the accuracy, clinical value and cost-effectiveness of tomographic bone imaging. MATERIALS AND METHODS: A total of 103 patients with initial diagnosis of lung cancer was prospectively examined with planar bone scintigraphy (BS), SPECT of the vertebral column and PET using F-18 sodium fluoride (F-18 PET). Receiver operating characteristic (ROC) curve analysis was used for determination of the diagnostic accuracy. A decision-analysis model and the national charge schedule of the German Hospital Association were used for determination of the cost-effectiveness. RESULTS: Thirteen of 33 patients with bone metastases were false negative on BS, 4 on SPECT, and 2 on F-18 PET. The area under the ROC curve was 0.771 for BS, 0.875 for SPECT, and 0.989 for F-18 PET (p < 0.05). As a result of SPECT and F-18 PET imaging, clinical management was changed in 8 (7.8%) and 10 (9.7%) patients. Compared with BS, the costs per additional correctly diagnosed patient were 1272 Euro with SPECT and 2861 Euro with F-18 PET. The threshold for the costs of F-18 PET being more cost-effective than SPECT was 345 EUR. CONCLUSION: Routine performance of tomographic bone imaging improves the therapeutic strategy because of detection of otherwise missed metastases. F-18 PET is more effective than SPECT but is associated with higher incremental costs.
UNLABELLED: As bone metastases might be present in lung cancer despite a normal bone scan, we examined various alternatives prospectively. Positron emission tomography using F-18sodium fluoride (PET) and single photon emission tomography (SPECT) were more sensitive than a planar bone scan. PET was more accurate with a shorter examination time than SPECT but had higher incremental costs. INTRODUCTION: Previous studies have shown that vertebral bone metastases not seen on planar bone scans may be present on F-18fluoride positron emission tomography (PET) scan or single photon emission computed tomography (SPECT). The purpose of this study was to measure the accuracy, clinical value and cost-effectiveness of tomographic bone imaging. MATERIALS AND METHODS: A total of 103 patients with initial diagnosis of lung cancer was prospectively examined with planar bone scintigraphy (BS), SPECT of the vertebral column and PET using F-18sodium fluoride (F-18 PET). Receiver operating characteristic (ROC) curve analysis was used for determination of the diagnostic accuracy. A decision-analysis model and the national charge schedule of the German Hospital Association were used for determination of the cost-effectiveness. RESULTS: Thirteen of 33 patients with bone metastases were false negative on BS, 4 on SPECT, and 2 on F-18 PET. The area under the ROC curve was 0.771 for BS, 0.875 for SPECT, and 0.989 for F-18 PET (p < 0.05). As a result of SPECT and F-18 PET imaging, clinical management was changed in 8 (7.8%) and 10 (9.7%) patients. Compared with BS, the costs per additional correctly diagnosed patient were 1272 Euro with SPECT and 2861 Euro with F-18 PET. The threshold for the costs of F-18 PET being more cost-effective than SPECT was 345 EUR. CONCLUSION: Routine performance of tomographic bone imaging improves the therapeutic strategy because of detection of otherwise missed metastases. F-18 PET is more effective than SPECT but is associated with higher incremental costs.
Authors: Karen A Kurdziel; Joanna H Shih; Andrea B Apolo; Liza Lindenberg; Esther Mena; Yolanda Y McKinney; Stephen S Adler; Baris Turkbey; William Dahut; James L Gulley; Ravi A Madan; Ola Landgren; Peter L Choyke Journal: J Nucl Med Date: 2012-06-22 Impact factor: 10.057
Authors: Frank I Lin; Jyotsna E Rao; Erik S Mittra; Kavitha Nallapareddy; Alka Chengapa; David W Dick; Sanjiv Sam Gambhir; Andrei Iagaru Journal: Eur J Nucl Med Mol Imaging Date: 2011-11-08 Impact factor: 9.236
Authors: Jennifer L Bain; Paul P Bonvallet; Ramzi V Abou-Arraj; Peter Schupbach; Michael S Reddy; Susan L Bellis Journal: Tissue Eng Part A Date: 2015-09 Impact factor: 3.845
Authors: M Beheshti; F M Mottaghy; F Paycha; F F F Behrendt; T Van den Wyngaert; I Fogelman; K Strobel; M Celli; S Fanti; F Giammarile; B Krause; W Langsteger Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-23 Impact factor: 9.236