J Cancer 2020; 11(17):4989-4995. doi:10.7150/jca.45096

Research Paper

A Retrospective Study of predicting risk of Metastasis among FDG-avid Bone Lesions in 18F-FDG PET/CT

Guangyu Yao1*, Yiyi Zhou1*, Yifeng Gu2, Zhiyu Wang1, Mengdi Yang1, Jing Sun1, Quanyong Luo3✉, Hui Zhao1✉

1. Department of Internal Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200030, China.
2. Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200030, China.
3. Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200030, China.
*These authors contributed equally to this work.

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Citation:
Yao G, Zhou Y, Gu Y, Wang Z, Yang M, Sun J, Luo Q, Zhao H. A Retrospective Study of predicting risk of Metastasis among FDG-avid Bone Lesions in 18F-FDG PET/CT. J Cancer 2020; 11(17):4989-4995. doi:10.7150/jca.45096. Available from https://www.jcancer.org/v11p4989.htm

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Abstract

Purpose: We evaluated the imaging and clinical features for discriminating the possibility of metastasis among FDG-avid bone lesions in 18F-FDG PET/CT in patients who have received bone biopsy.

Methods: The retrospective study included patients who underwent both 18F-FDG PET/CT and bone biopsy for FDG-avid bone lesions. Bone lesions maximum standardized uptake value (SUVmax), CT findings, alongside with common clinical features were analyzed.

Results: From the 338 patients enrolled in the final study, all of them were received bone biopsy. Biopsies confirm metastasis in 256 cases (75.74%) and benign tissue in 82 cases (24.26%). Metastasis group had higher bone SUVmax than benign group (median 7.9 vs 4.5, p <0.001). A cutoff bone SUVmax of 5 achieved an AUC of 0.748 in all patients. Lytic CT feature and higher age were more likely frequent in metastasis group. Moreover, in patients without obvious CT abnormality (45, 13.31%), the AUC was 0.743 by a SUVmax cutoff of 5.38, whilst in patients with a solitary bone lesion (74, 21.89%), the AUC was 0.803 by a SUVmax cutoff of 4.3.

Conclusions: SUVmax is a promising and valuable metabolic indicator for predicting risk of metastasis among FDG-avid bone lesions in 18F-FDG PET/CT, ancillary clinical and imaging features may increase the probability of a metastatic bone lesion.

Keywords: Bone metastasis, Biopsy, PET/CT, SUVmax