Evaluation of the Clinical Value of Bone Metabolic Parameters and Radiology Imaging Methods for the Screening Of Bone Metastases Compared to Bone Scintigraphy

Purpose: More than % of bone cancers are metastases which derive from another primary cancer. Detection of bone metastases in their initially developed stage until the period without clinical signs was the goal of interest. Methods: One hundred five patients with cancer disease were included in our perspective study during 2002-2005. Patients without preliminary biochemistry analyses, radiological data and bone scintigraphy, were not included in the study, whereas we made exceptions for CT and MRI examinations because some patients didnʹt made them. Bone scintigraphy was performed after clinical examination of all patients, three hours after intravenous administration of 555-740 MBq activity of 99mTc MDP Results: From the overall number, seventy two patients were female (68.57%). The patients with breast cancer (62) were the most frequent group (59.04%). Prostate cancer was registered in 19 male patients (18.09%), whereas lung cancer was registered in 5 cases (4.7%). Bone metastases were registered in 85 patients (80.95%). The sensitivity of bone scintigraphy was 98%, its specificity 95%, resulting in a diagnostic efficiency of 98%. The positive predictive value was calculated to be 98% and the negative one to be 95%. The concentrations of the bone markers, TAP ESR, blood calcium, CEA, CA 15.3 and PSA were significantly higher in patients with bone metastasis than in those without bone metastasis (p<0.01). The sensitivity of (CRI) conventional radiology imaging was 21%, its specificity 60%, the efficiency 30%, whereas PPV was calculated to be 62% and NPV 19%. The sensitivity of CT was 64.7%, its specificity 86%, efficiency 70%, whereas PPV 91% and NPV 51%. The sensitivity and specificity of MRI were 96%, 92% respectively. The diagnostic efficiency of MRI was 94%, whereas PPW and NPV were calculated to be 96%, 92% respectively. Conclusion: Bone scintigraphy proceeds to be the method of choice which resolves all diagnostic problems concerning bone metastases. Biochemistry findings and radiology imaging methods should be considered no more efficient for early detection of bone metastases.