The Role of FDG-PET/CT in Detecting Bone Metastases: Insights from Two Case Reports

Author(s):  Esilda Trushaj, Juliana Shahu, Arben Dhima, Elda Shahu

Background: The detection of bone metastasis is a crucial element of managing oncological patients based on the fact that its presence takes a great importance in staging, treatment strategies, prognosis and the overall management of the patients. 18F-FDG PET/CT combines both metabolic and anatomical information and offers superior reliability compared to other imaging modalities.
Case presentation: We report two cases where 18F-FDG PET/CT plays an important role in detecting bone metastases that were undetected with other imaging modalities. These findings influenced in disease staging and overall treatment planning of the patient.
Discussion: In our hospital center we use both bone FDG PET/CT and bone scintigraphy, the last one is more indicated if there is any suspicion for bone metastasis, due to low cost. On the contrary, it is evaluated that PET/CT has brought us higher sensitivity and specificity with low false negative. PET/CT detects bone marrow lesions mainly based on their increased metabolic activity rather than on anatomical alterations.
Conclusion: FDG-PET/CT is the appropriate diagnostic modality in detection and evaluation of bone metastases. It has very high specificity and sensitivity when performed according to protocol and the combined metabolic and anatomical information make it important in oncologic patients.