Back to Search
Start Over
The role of whole-body bone scanning and clinical factors in detecting bone metastases in patients with non-small cell lung cancer.
- Source :
-
Chest [Chest] 2005 Feb; Vol. 127 (2), pp. 449-54. - Publication Year :
- 2005
-
Abstract
- Study Objectives: Correct detection of bone metastases in patients with non-small cell lung cancer (NSCLC) is crucial for prognosis and selection of an appropriate treatment regimen. The aim of this study was to investigate the role of whole-body bone scanning (WBBS) and clinical factors in detecting bone metastases in NSCLC.<br />Design and Patients: One hundred twenty-five patients with a diagnosis made between 1998 and 2002 were recruited (squamous cell carcinoma, 54.4%; adenocarcinoma, 32.8%; non-small cell carcinoma, 8.8%; large cell carcinoma, 4%). Clinical factors suggesting bone metastasis (skeletal pain, elevated alkaline phosphatase, hypercalcemia) were evaluated. WBBS was performed in all patients, and additional MRI was ordered in 10 patients because of discordance between clinical factors and WBBS findings.<br />Measurements and Results: Bone metastases were detected in 53% (n = 21) of 39 clinical factor-positive patients, 5.8% (n = 5) of 86 clinical factor-negative patients, and 20.8% of total patients. The existence of bone-specific clinical factors as indicators of metastasis presented 53.8% positive predictive value (PPV), 94.2% negative predictive value (NPV), and 81.6% accuracy. However, the findings of WBBS showed 73.5% PPV, 97.8% NPV, and 91.2% accuracy. Adenocarcinoma was the most common cell type found in patients with bone metastasis (39%). The routine bone scanning prevented two futile thoracotomies (8%) in 25 patients with apparently operable lung cancer.<br />Conclusions: In spite of the high NPV of the bone-specific clinical factors and the high value obtained in the false-positive findings in the bone scan, the present study indicates that in patients for whom surgical therapy is an option, preoperative staging using WBBS can be helpful to avoid misstaging due to asymptomatic bone metastases.
- Subjects :
- Adult
Aged
Alkaline Phosphatase blood
Biopsy, Needle
Bone Neoplasms blood
Bone Neoplasms pathology
Bone and Bones diagnostic imaging
Bone and Bones pathology
Carcinoma, Non-Small-Cell Lung blood
Carcinoma, Non-Small-Cell Lung diagnostic imaging
Carcinoma, Non-Small-Cell Lung pathology
Female
Humans
Hypercalcemia blood
Lung Neoplasms blood
Lung Neoplasms pathology
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging
Pain diagnostic imaging
Pain etiology
Predictive Value of Tests
Radionuclide Imaging
Retrospective Studies
Statistics as Topic
Bone Neoplasms diagnostic imaging
Bone Neoplasms secondary
Carcinoma, Non-Small-Cell Lung secondary
Lung Neoplasms diagnostic imaging
Whole-Body Counting
Subjects
Details
- Language :
- English
- ISSN :
- 0012-3692
- Volume :
- 127
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Chest
- Publication Type :
- Academic Journal
- Accession number :
- 15705981
- Full Text :
- https://doi.org/10.1378/chest.127.2.449