[18F]FDG PET/CT performs better than CT in determining the bone biopsy site : randomized controlled clinical trial

Abstract

Abstract Background Bone biopsy is the gold standard for diagnosing bone metastases. However, there is no clinical consensus regarding the optimal imaging test for determining the puncture site. Methods We compared the performance of [18F]FDG PET/CT with CT in detecting bone metastases to achieve the highest biopsy efficiency. This registered prospective study enrolled 273 patients with bone lesions who were treated between January 2020 and March 2021. Patients were randomly assigned to undergo [18F]FDG PET/CT or CT to determine the puncture site before bone biopsy. The accuracy, sensitivity, specificity, second biopsy rate, diagnostic time and cost-effectiveness of the two imaging tests were compared. Results The accuracy and sensitivity of [18F]FDG PET/CT group in detecting bone metastases were significantly higher than CT group(97.08% vs. 90.44%, 98.76% vs. 92.22%, P 6.3 combined with ALP > 103 U/L showed a tendency for tumor metastases with an AUC of 0.901 (95%CI 0.839 to 0.946, P < 0.001). Conclusion [18F]FDG PET/CT has better performance and cost-effectiveness than CT in determining the bone biopsy site for suspect bone metastases. Trial registration The prospective study was registered on 2018-04-10, and the registration number is ChiCTR1800015540.

Keywords

• Bone metastasis
• Diagnostic test
• Imaging
• Positron emission tomography
• Computed tomograph
• Clinical trial results