Table 1. Detection of metastatic bone disease from carcinoma of the prostate: summary of prospective studies over the past 10 years.
| Imaging modality | Structure/mechanism measured | Reference | Patients | Gold standard used | Sensitivity (%) | Specificity (%) |
|---|---|---|---|---|---|---|
| Planar MDP bone scintigraphy | Osteoblast activity | Lecouvet et al (2007) | 66 | Consensus decision using bone scintigraphy, CT, MRI, follow-up, clinical and serum markers | 46 | 32 |
| Even-Sapir et al (2006) | 44 | Consensus decision using 18F-fluoride PET/CT, and follow-up | 69 | 64 | ||
| SPECT | Even-Sapir et al (2006) | 20 | Consensus decision using 18F-fluoride PET/CT, and follow-up | 92 | 82 | |
| MRI | Bone marrow | Lecouvet et al (2007) | 66 | Consensus decision using F/U bone scintigraphy, CT, MRI and clinical and serum markers | 100 | 88 |
| DW MRI | Bone marrow microstructure | Luboldt et al (2008) | 11 | 11C-choline used as gold standard. In all, 15 true-positive bone metastases were identified by DWI, 15 by STIR and 14 true positives identified on T1W imaging | NA | NA |
| 18FDG PET | Glucose metabolism | Morris et al (2002) | 17 | Consensus decision using bone scintigraphy. In all, 71% lesions visible on both modalities, 23% only on bone scan and 6% only on FDG PET | NA | NA |
| Shreve et al (1996) | 22 | Consensus decision using bone scintigraphy and follow-up | 65 | |||
| 18F-fluoride PET/CT | Osteoblast activity | Even-Sapir et al (2006) | 44 | Consensus decision using bone scintigraphy and follow-up | 100 | 100 |
| Beheshti et al (2008) | 38 | Consensus decision using 18F-fluorocholine PET/CT and follow-up | 81 | 93 | ||
| 18F-fluorocholine PET/CT | Bone marrow – cellularity | Beheshti et al (2008) | 38 | Consensus decision using 18F-fluoride PET/CT and follow-up | 99 | 85 |
| 11C-choline PET | Bone marrow – cellularity | Kotzerke et al (2000) | 23 | Consensus decision using bone scintigraphy. 11C-choline PET-matched bone scintigraphy for lesion detection | NA | NA |
Abbreviations: CT= computerised tomography; DWI=diffusion-weighted imaging; MDP=methylene diphosphonate; MRI= magnetic resonance imaging; PET=positron emission tomography; SPECT=single-photon emission computerised tomography; STIR= short tau inversion recovery; SUV=standardised uptake value; 18FDG=18F-fluorodeoxyglucose.