A meta-analysis of ¹⁸F PET/CT for the diagnosis of bone metastasis

Objective: Sodium (¹⁸F) fluoride injection is a radioactive diagnostic agent for positron emission tomography (PET) indicated for imaging of bone to define areas of altered osteogenic activity. The diagnosis of bone metastasis is one of its important indications. The objective of this study was to systematically evaluate the diagnosis effect of Na ¹⁸F PET/CT for the diagnosis of bone metastases. Methods: The literatures about Na ¹⁸F PET/CT for the diagnosis of bone metastases, published between January 1,2000 to December 31, 2018, were computationally searched in both the English database and the Chinese database. The qualified literatures were selected according to the inclusive and exclusive standards. Data extraction and quality evaluation were the performed. A meta-analysis was performed using Stata 12.00 software. Based on the searching, a total of 35 literatures were selected in this study, including 9 Chinese literatures and 26 English literatures. Results: The results of the meta-analysis showed that: (1) The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the area under the curve of Na ¹⁸F PET/CT in the diagnosis of bone metastasis were 0.9, 0.93, 14.5 0.03 and 0.99 based on the patients, respectively. Based on the lesions, these results were 0.96, 0.88, 8.3, 0.05 and 0.98 respectively; (2) The intercomparison of ROC curves of different primary lesions (lung cancer, breast cancer and prostate cancer) showed that there were no significant differences among these three types of primary lesions; (3) There were no reports of adverse reactions after the use of Na ¹⁸F in all the literatures in this study. Conclusion: Na ¹⁸F PET/CT has a good performance in the diagnosis of bone metastasis, based on both the patients or the lesions. There are no significant differences in the diagnosis of bone metastasis of lung cancer, breast cancer and prostate cancer, and no adverse reactions have been reported after the use of Na ¹⁸F. (authors)