Mine Benedicte Lange1, Mads Lausen Nielsen2, Jeannette Demant Andersen2, Hanna Järnum Lilholt2, Mogens Vyberg3, Lars Jelstrup Petersen4. 1. Department of Radiology, Aalborg University Hospital, Aalborg, Denmark. Electronic address: bl@benedictelange.dk. 2. Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark. 3. Institute of Pathology, Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 4. Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
OBJECTIVES: To examine the diagnostic accuracy of imaging modalities in skeletal tumours versus pathology reports. MATERIALS AND METHODS: Pathology reports of bone biopsies were compared to diagnostic imaging with X-ray, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy (BS), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) performed within 6 months of biopsy. RESULTS: A total of 409 biopsies were included. Sensitivity and specificity were significantly different among the five modalities (p<0.0001). The sensitivity of MRI and PET/CT was better than CT, but CT had a better specificity than PET/CT. In general, these methods outperformed BS and X-ray. The sensitivity for osteolytic lesions varied significantly between modalities (p<0.0001), with MRI and PET/CT being more sensitive than CT. Differences in sensitivity were also observed in mixed lesions (p=0.0002) but not in osteosclerotic lesions. In spine lesions, MRI showed the best sensitivity followed by PET/CT and CT (p<0.0005 vs. MRI). There was no significant differences among non-spine lesions. CONCLUSIONS: MRI and FDG-PET/CT showed comparable diagnostic characteristics in general, in individual tumour types, and in different bone lesions and locations. Nominally, they outperformed CT in most situations. The diagnostic accuracy of X-ray and BS were notably inferior to other modalities.
OBJECTIVES: To examine the diagnostic accuracy of imaging modalities in skeletal tumours versus pathology reports. MATERIALS AND METHODS: Pathology reports of bone biopsies were compared to diagnostic imaging with X-ray, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy (BS), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) performed within 6 months of biopsy. RESULTS: A total of 409 biopsies were included. Sensitivity and specificity were significantly different among the five modalities (p<0.0001). The sensitivity of MRI and PET/CT was better than CT, but CT had a better specificity than PET/CT. In general, these methods outperformed BS and X-ray. The sensitivity for osteolytic lesions varied significantly between modalities (p<0.0001), with MRI and PET/CT being more sensitive than CT. Differences in sensitivity were also observed in mixed lesions (p=0.0002) but not in osteosclerotic lesions. In spine lesions, MRI showed the best sensitivity followed by PET/CT and CT (p<0.0005 vs. MRI). There was no significant differences among non-spine lesions. CONCLUSIONS: MRI and FDG-PET/CT showed comparable diagnostic characteristics in general, in individual tumour types, and in different bone lesions and locations. Nominally, they outperformed CT in most situations. The diagnostic accuracy of X-ray and BS were notably inferior to other modalities.
Keywords:
Bone metastasis/neoplasms/tumours; Computed tomography Imaging; Diagnostic accuracy; Magnetic resonance imaging; Positron emission tomography with computed tomography; Sensitivity and specificity
Authors: Jad S Husseini; Bárbara Juarez Amorim; Angel Torrado-Carvajal; Vinay Prabhu; David Groshar; Lale Umutlu; Ken Herrmann; Lina García Cañamaque; José Ramón García Garzón; William E Palmer; Pedram Heidari; Tiffany Ting-Fang Shih; Jacob Sosna; Cristina Matushita; Juliano Cerci; Marcelo Queiroz; Valdair Francisco Muglia; Marcello H Nogueira-Barbosa; Ronald J H Borra; Thomas C Kwee; Andor W J M Glaudemans; Laura Evangelista; Marco Salvatore; Alberto Cuocolo; Andrea Soricelli; Christian Herold; Andrea Laghi; Marius Mayerhoefer; Umar Mahmood; Ciprian Catana; Heike E Daldrup-Link; Bruce Rosen; Onofrio A Catalano Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-22 Impact factor: 9.236