Detection of bone metastases in non-small cell lung cancer patients: Comparison of whole-body diffusion-weighted imaging (DWI), whole-body MR imaging without and with DWI, whole-body FDG-PET/CT, and bone scintigraphy

Purpose To prospectively compare the capability for bone metastasis assessment of whole‐body diffusion‐weighted imaging (DWI), magnetic resonance imaging (MRI) without and with DWI, [18F] fluoro‐2‐D‐glucose positron emission tomography with computed tomography (FDG‐PET/CT) and bone scintigraphy in non‐small cell carcinoma (NSCLC) patients. Materials and Methods In all, 115 consecutive NSCLC patients (66 men, 49 women; mean age 72 years) prospectively underwent whole‐body MRI, PET/CT, and bone scintigraphy before treatment. For each method, probability of metastasis was independently assessed by using a 5‐point visual scoring system on a per‐site basis. Receiver operating characteristic (ROC)‐based positive tests were used to determine the practical threshold value for each method on a per‐site basis. Sensitivities, specificities, and accuracies were then compared on a per‐site and per‐patient basis by means of McNemar's test. Results When the practical threshold values were adapted, specificity and accuracy of whole‐body MRI with DWI were significantly higher than those of bone scintigraphy and PET/CT (P < 0.05). On a per‐patient basis, specificity and accuracy of whole‐body MRI with DWI were significantly higher than those of bone scintigraphy (P < 0.05). Conclusion Whole‐body MRI with DWI can be used for bone metastasis assessment of NSCLC patients as accurate as bone scintigraphy and/or PET/CT. J. Magn. Reson. Imaging 2009;30:298–308. © 2009 Wiley‐Liss, Inc.