Abstract：Objective This study aims to explore the application value of 18F-fluorodeoxyglucose (18F-FDG) positron emission computed tomography (PET)/CT in the differential diagnosis of bone metastasis of lung cancer, bone metastasis of prostate cancer, and multiple myeloma (MM). Methods The study was cross-sectional. The clinical data of 42 patients with bone metastasis of lung cancer, 30 patients with bone metastasis of prostate cancer, and 36 patients with MM treated in the First Affiliated Hospital of Xi'an Jiaotong University from November 2020 to November 2022 were analyzed retrospectively, including 78 males and 30 females, aged 33 to 87 years. All patients underwent 18F-FDG PET/CT examination. They were divided into the lung cancer group, prostate cancer group, and MM group. Differences in 18F-FDG PET/CT examination results of lesion distribution, bone destruction, and maximum standardized uptake value (SUVmax) were analyzed. Results Significant differences in age and gender were observed among the three groups (F=9.63, χ2=17.17,all P values <0.001). More than 70% of the bone lesions in the three groups involved the ribs, spine, and pelvis, followed by the limbs. There were significant differences in ribs, pelvis, limbs and skull among the three groups (all P values <0.05). There were no significant differences in spine and sternum (all P values >0.05). Comparison of lesion distribution between groups showed that: 96.7%(29/30) and 53.3%(16/30) lesions occurred in the pelvis and limbs in the prostate cancer group, respectively, which were higher than those in the lung cancer group(71.4%[30/42] and 19.0%[8/42], respectively), with statistical significance(all P values <0.05). More lesions occurred in the ribs of MM group than in the prostate cancer group [100%(36/36) and 70%(21/30)], less lesions occurred in the pelvis(72.2%[26/30]) than in the prostate cancer group(96.7%[29/30]), and more lesions occurred in the skull than in the prostate cancer group and lung cancer group(55.6%[20/36], 6.7% [2/30], 4.8%[2/42], respectively). All the differences were statistically significant (all P values <0.05). A significant difference in the type of bone destruction was observed among the three groups (χ2=82.94, P<0.001). Bone destruction in the lung cancer group and MM group was primarily due to osteolytic lesions (81.0%[34/42] and 94.4%[34/36], respectively), and bone destruction caused by osteoblastic lesions was less observed (7.1%[3/42] and 2.8%[1/36], respectively). Some mixed lesions were also observed (11.9%[5/42] and 2.8%[1/36]). In the prostate cancer group, osteoblastic lesions were predominant (90.0%[27/30]). With regard to metabolic characteristics, SUVmax in the lung cancer group, prostate cancer group, and MM group showed a high-to-low order (F=54.66, P < 0.001). Conclusion18F-FDG PET/CT can be used to evaluate the bone structure and metabolic characteristics in lung cancer, prostate cancer, and MM, and has a high value in the differential diagnosis.
高俊刚, 尚宇, 刘翔, 梁宇霞, 王博, 段小艺, 牛晨, 刘军. 18F-FDG PET/CT显像对肺癌骨转移、前列腺癌骨转移与多发性骨髓瘤的鉴别诊断[J]. 中华解剖与临床杂志, 2024, 29(1): 1-8.
Gao Jungang, Shang Yu, Liu Xiang, Liang Yuxia, Wang Bo, Duan Xiaoyi, Niu Chen, Liu Jun. Differential diagnosis of bone metastasis of lung cancer, bone metastasis of prostate cancer, and multiple myeloma by 18F-FDG PET/CT imaging. Chinese Journal of Anatomy and Clinics, 2024, 29(1): 1-8.
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