MULTIMODAL APPROACH TO THE DIAGNOSIS OF BONE METASTASES USING COMPUTED TOMOGRAPHY, POSITRON EMISSION TOMOGRAPHY WITH COMPUTED TOMOGRAPHY AND OSTEOSCINTIGRAPHY

Authors:

Abstract:

The purpose of the study was to conduct a comparative analysis of the results of computed tomography, positron emission tomography combined with computed tomography, and osteoscintigraphy in the diagnosis of bone metastases. The diagnostic value and consistency levels of these methods in oncology patients were investigated. The results showed that positron emission tomography combined with computed tomography demonstrates higher diagnostic accuracy in detecting bone metastases and has the ability to provide additional complementary information in cases of discrepancy. Although computed tomography is useful in morphological assessment, in some cases its sensitivity in detecting metastases may be lower. Osteoscintigraphy, while suitable for widespread screening, may result in non-specific findings. Based on the obtained results, practical recommendations for diagnostic conclusions were proposed.

Keywords:

bone metastasis positron emission tomography combined with computed tomography computed tomography osteoscintigraphy diagnostic concordance radiological examination SUV max

References:

1. Chang Y, Gu Y, Ruan S, Zhang L, Jin Z, Jiang Y, et al. [¹⁸F] FDG PET/CT performs better than CT in determining the bone biopsy site: a randomized controlled clinical trial. Cancer Imaging. 2024;24(1):160. doi:10.1186/s40644-024-00778-6.
2. Chavoshi M, Mirshahvalad SA, Zamani S, Radmard AR, Fallahi B, Mousavi SA. Whole body low dose CT can be of value in prostate cancer decision making: a retrospective study on 601 patients. Insights Imaging. 2023;14:124. doi:10.1186/s13244-023-01475-w.
3. Fan Z, Wang T, Zou L, Liu D. Comparison of the diagnostic value of 18F-NaF PET/CT and 99mTc-MDP SPECT for bone metastases: a systematic review and meta-analysis. Transl Cancer Res. 2023 Nov 30;12(11):3166-3178. doi: 10.21037/tcr-23-817.
4. Gerke O, Naghavi-Behzad M, Nygaard ST, Sigaroudi VR, Vogsen M, Vach W, et al. Diagnosing bone metastases in breast cancer: a systematic review and network meta-analysis on diagnostic test accuracy studies of 2-[18F]FDG PET/CT, 18F NaF PET/CT, MRI, contrast-enhanced CT, and bone scintigraphy. Semin Nucl Med. 2025;55(1):137–51. doi:10.1053/j.semnuclmed.2024.10.008.
5. Ibrahim A, Vaidyanathan A, Primakov S, Belmans F, Bottari F, Refaee T, et al. Deep learning based identification of bone scintigraphies containing metastatic bone disease foci. Cancer Imaging. 2023;23:12. doi:10.1186/s40644-023-00556-w.
6. Jin H, Veeramachaneni N. Bone Metastasis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567769/
7. Li R, Ravizzini GC, Gorin MA, Maurer T, Eiber M, Cooperberg MR, et al. The use of PET/CT in prostate cancer. Prostate Cancer Prostatic Dis. 2018;21(1):4–21. doi:10.1038/s41391-017-0007-8.
8. Madsen C, Fuglø D, Pedersen M, Broholm R, Østergren PB, Bisbjerg R, et al. Prospective Head-to-Head Comparison of 18F-PSMA PET/CT and 18F-NaF PET/CT for Assessing Bone Metastases in 160 Patients with Newly Diagnosed High-Risk Prostate Cancer. J Nucl Med. 2025 Feb 3;66(2):223-229. doi: 10.2967/jnumed.124.268275.
9. Omnia M, Abd Elaziz M, Dahou A, Ewees AA, Elgarayhi A, Sallah M, et al. Bone scintigraphy based on deep learning model and modified growth optimizer. Sci Rep. 2024;14:25627. doi:10.1038/s41598-024-57013-z.
10. Orcajo-Rincon J, Muñoz-Langa J, Sepúlveda-Sánchez JM, Fernández-Pérez GC, Martínez M, Noriega-Álvarez E, et al. Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer. Clin Transl Oncol. 2022;24(7):1290–310. doi:10.1007/s12094-022-02784-0.
11. Papandrianos N, Papageorgiou EI, Anagnostis A, Papageorgiou K. Efficient bone metastasis diagnosis in bone scintigraphy using a fast convolutional neural network architecture. Curr Med Imaging. 2020;16(8):914–21. doi:10.2174/1573405616666200228113304.
12. Pu F, Hu Z, Yang Y, Xia P, Xia Z. Editorial: diagnosis and treatment of bone metastases. Front Oncol. 2023;13:1247231. doi:10.3389/fonc.2023.1247231.
13. Santos JC, Abreu MH, Santos MS, Duarte H, Alpoim T, Próspero I, et al. Bone metastases detection in patients with breast cancer: does bone scintigraphy add information to PET/CT? Oncologist. 2023;28(5):oyad087. doi:10.1093/oncolo/oyad087.
14. Schwarz L, Müller A, Becker J, et al. Generative AI enhanced synthesis of bone scintigraphy images to improve deep learning detection of bone metastases. Eur J Nucl Med Mol Imaging. 2025;52(6):1203–15. doi:10.1007/s00259-025-07091-8.
15. Zhao G, Ji B. Head-To-Head Comparison of 68Ga-PSMA-11 PET/CT and 99mTc-MDP Bone Scintigraphy for the Detection of Bone Metastases in Patients With Prostate Cancer: A Meta-Analysis. AJR Am J Roentgenol. 2022 Sep;219(3):386-395. doi: 10.2214/AJR.21.27323.

Publication:

«World of Medicine and Biology» Vol. 22 No. 1 (2026) , с. 129-134
УДК 616.71-006.48-073.75/.756

DOI:

https://doi.org/10.26724/2079-8334-2026-1-95-129-134