TY - JOUR
T1 - Diagnostic accuracy of imaging methods for the diagnosis of skeletal malignancies
T2 - A retrospective analysis against a pathology-proven reference
AU - Lange, Mine Benedicte
AU - Nielsen, Mads Lausen
AU - Andersen, Jeannette Demant
AU - Lilholt, Hanna Järnum
AU - Vyberg, Mogens
AU - Petersen, Lars Jelstrup
N1 - Copyright © 2015. Published by Elsevier Ireland Ltd.
PY - 2016
Y1 - 2016
N2 - OBJECTIVES: To examine the diagnostic accuracy of imaging modalities in skeletal tumours versus pathology reports.MATERIALS AND METHODS: Pathology reports of bone biopsies were compared to diagnostic imaging with X-ray, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy (BS), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) performed within 6 months of biopsy.RESULTS: A total of 409 biopsies were included. Sensitivity and specificity were significantly different among the five modalities (p<0.0001). The sensitivity of MRI and PET/CT was better than CT, but CT had a better specificity than PET/CT. In general, these methods outperformed BS and X-ray. The sensitivity for osteolytic lesions varied significantly between modalities (p<0.0001), with MRI and PET/CT being more sensitive than CT. Differences in sensitivity were also observed in mixed lesions (p=0.0002) but not in osteosclerotic lesions. In spine lesions, MRI showed the best sensitivity followed by PET/CT and CT (p<0.0005 vs. MRI). There was no significant differences among non-spine lesions.CONCLUSIONS: MRI and FDG-PET/CT showed comparable diagnostic characteristics in general, in individual tumour types, and in different bone lesions and locations. Nominally, they outperformed CT in most situations. The diagnostic accuracy of X-ray and BS were notably inferior to other modalities.
AB - OBJECTIVES: To examine the diagnostic accuracy of imaging modalities in skeletal tumours versus pathology reports.MATERIALS AND METHODS: Pathology reports of bone biopsies were compared to diagnostic imaging with X-ray, computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy (BS), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) performed within 6 months of biopsy.RESULTS: A total of 409 biopsies were included. Sensitivity and specificity were significantly different among the five modalities (p<0.0001). The sensitivity of MRI and PET/CT was better than CT, but CT had a better specificity than PET/CT. In general, these methods outperformed BS and X-ray. The sensitivity for osteolytic lesions varied significantly between modalities (p<0.0001), with MRI and PET/CT being more sensitive than CT. Differences in sensitivity were also observed in mixed lesions (p=0.0002) but not in osteosclerotic lesions. In spine lesions, MRI showed the best sensitivity followed by PET/CT and CT (p<0.0005 vs. MRI). There was no significant differences among non-spine lesions.CONCLUSIONS: MRI and FDG-PET/CT showed comparable diagnostic characteristics in general, in individual tumour types, and in different bone lesions and locations. Nominally, they outperformed CT in most situations. The diagnostic accuracy of X-ray and BS were notably inferior to other modalities.
U2 - 10.1016/j.ejrad.2015.10.012
DO - 10.1016/j.ejrad.2015.10.012
M3 - Journal article
C2 - 26724650
SN - 0720-048X
VL - 85
SP - 61
EP - 67
JO - European Journal of Radiology
JF - European Journal of Radiology
IS - 1
ER -