Comparison of 18FDG PET-CT and bone scintigraphy for detection of bone metastases in breast cancer patients. A meta-analysis

Background: We performed a meta-analysis to compare the accuracy of (18)FDG PET-CT and bone scintigraphy for the detection of bone metastases in breast cancer patients. Methods: Studies about (18)FDG PET-CT and bone scintigraphy for the detection of bone metastases in breast cancer patients were systematically searched in the MEDLINE and EMBASE databases. We calculated sensitivities, specificities, diagnostic odds ratios, and likelihood ratios, and constructed summary receiver operating characteristic curves using bivariate regression models for (18)FDG PET-CT and bone scintigraphy, respectively. Results: Across 7 studies (668 patients), sensitivity and specificity of PET-CT 0.93 (95% confidence interval [CI] = 0.82-0.98) and 0.99 (95% CI = 0.95-1.00), and of bone scintigraphy were 0.81 (95% CI = 0.58-0.93) and 0.96 (95% CI = 0.76-1.00), respectively. Area under curves for PET-CT and bone scintigraphy was 0.98 (95% CI = 0.98-1.00) and 0.94 (95% CI = 0.92-0.96), respectively. Conclusions: Compared with bone scintigraphy, (18)FDG PET-CT may higher sensitivity and accuracy for detection of bone metastases in breast cancer patients. (C) 2013 Elsevier Ltd. All rights reserved.