Abstract:
Objective To explore the value of 99Tcm-methylene diphosphate (MDP) whole-body bone imaging in the diagnosis of bone metastasis of lung cancer.
Methods Retrospective analysis was conducted on the clinical data of 118 lung cancer patients admitted to General Hospital of Huainan Oriental Hospital Group from December 2019 to December 2022, including 62 males and 56 females, aged (69.5±7.6) years, with a range of 51–84 years old. Before treatment, all patients underwent 99Tcm-MDP whole-body bone imaging. After the examination, the results of 99Tcm-MDP whole-body bone imaging, histopathological examination, and follow-up were subjected to analysis. Kappa analysis was used to analyze the consistency between the results of 99Tcm-MDP whole-body bone imaging and histopathological examination and evaluate the importance of 99Tcm-MDP whole-body bone imaging in the diagnosis of lung cancer bone metastasis. Chi square test was used to compare the sensitivity, specificity, accuracy, and positive and negative predictive values of bone metastasis in different parts of lung cancer (chest bone, axial bone, pelvic bone, and limb bone).
Results Among 118 lung cancer patients, 60 cases (50.85%) were confirmed to have bone metastases through histopathological examination. These confirmed cases included 2 cases of skull metastases (3.33%), 10 cases of chest bone metastases (16.67%), 29 cases of axial bone metastases (48.33%), 12 cases of pelvic bone metastases (20.00%), and 7 cases of limb bone metastases (11.67%). The 99Tcm-MDP whole-body bone imaging results reveal that 57 cases (48.31%) were positive for bone metastases, including 10 cases of chest bone metastases (17.54%), 27 cases of axial bone metastases (47.37%), 11 cases of pelvic bone metastases (19.30%), and 9 cases of limb bone metastases (15.79%). Kappa analysis results indicate a strong consistency between 99Tcm-MDP whole-body bone imaging and histopathological examination in the diagnosis of lung cancer bone metastasis (Kappa value=0.839, P<0.001) and in the diagnosis of bone metastasis in various parts of lung cancer (Kappa value=0.648–0.732, all P<0.001). The sensitivity, specificity, accuracy, and positive and negative predictive values of 99Tcm-MDP whole-body bone imaging for the diagnosis of lung cancer bone metastasis were 81.67% (49/60), 86.21% (50/58), 83.90% (99/118), 85.96% (49/57), and 81.97% (50/61), respectively. No significant statistical difference was observed in the sensitivity, specificity, accuracy, and negative predictive value of lung cancer with chest bone, axial bone, pelvic bone, and limb bone metastases (χ2=1.790–9.136, all P>0.05). The positive predictive values of 99Tcm-MDP whole-body bone imaging for chest and limb bone metastases in lung cancer are lower than those of axial and pelvic bone metastases (all P<0.05).
Conclusion 99Tcm-MDP whole-body bone imaging exhibits a high diagnostic value in the diagnosis of lung cancer bone metastasis, which is worth the attention of clinical physicians.
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