which test? PET/CT vs bone scan for bone mets--methods compared, PET/CT

[Lani]

better in many respects--study included 97 patients, so larger study needed before standard of care change considered, probably


Study comparing the concordance between PET/CT and bone scan in detecting skeletal metastasis in breast cancer patients.


Sub-category:
HER2+

Category:
Breast Cancer - HER2/ER

Meeting:
2011 ASCO Annual Meeting

Abstract No:
e11122

Citation:
J Clin Oncol 29: 2011 (suppl; abstr e11122)


Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2011 Annual Meeting but not presented at the Meeting, can be found online only.

The publication-only abstracts are not included in the print or USB versions of the ASCO Annual Meeting Proceedings Part I, but they are citable to the Journal of Clinical Oncology as a supplement (see citation on left).

Author(s): D. Landau, S. M. Constantino, S. Maddipatla, Z. J. Zhang, M. Hart, N. C. Shah, S. Baidas; M. D. Anderson Cancer Center Orlando, Orlando, FL; University of Central Florida, Orlando, FL


Abstract Disclosures


Abstract:

Background: Bone metastasis is the most common site of metastases from breast cancer. Bone scan using technetium-99m is widely used for the detection of bony metastasis in patients with breast cancer but specificity is lowered by benign processes and sensitivity is lessened by poor detection of osteolytic metastasis. Positron emission tomography (PET) using 2-[18F] - fluoro-2-deoxy-D-glucose is a useful tool for the detection of metastatic disease in patients with breast cancer. It is unclear whether one or both modalities should be used to detect bone metastasis. Methods: Within our institution, we reviewed PET/CT scans and bone scans from 97 female patients with breast cancer whose scans were within a 4 -week period between June 2007 and March 2010 (109 studies of each, PET scan and bone scan). Data was divided into three sites: spine, pelvis+ribs, extremities. All scans were reviewed by 2 independent expert nuclear medicine physicians. Utilizing bone scan as the standard, McNemar’s test was performed to examine the marginal homogeneity of diagnoses for each of the three locations. The sensitivity, specificity, and accuracy of PET scan as opposed to bone scan were compared. Results: See table. Conclusions: There is no statistical difference between PET/CT scan compared with bone scan when bone scan is utilized as the standard test for detection of skeletal metastasis. In addition, using bone scan as a standard, PET scan has higher sensitivity (lower false-positive rates) in detecting spine metastasis, higher specificity (lower false-negative rates), and accuracy in detecting extremity metastasis.


Spine Pelvis/Rib Extremity Overall
PET +/bone scan + 35 31 10 76
PET +/bone scan - 8 8 8 24
PET -/bone scan + 7 9 6 22
PET -/bone scan - 59 61 85 205
Sensitivity 83.3% 77.5% 62.5% 77.6%
Specificity 88.1% 87.1% 91.4% 89.5%
Accuracy 86.2% 84.4% 87.2% 85.9%
p value 1.000 1.000 0.791 0.883