Original Article   

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 Jun 28

DOI: 10.23736/S1824-4785.22.03444-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Risk factors for rib metastases of lung cancer patients with high-uptake rib foci on 99Tcm-MDP SPECT/CT

Yuanyuan YANG, Rongqin FAN, Xiaoliang CHEN ✉

Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Nuclear Medicine, Chongqing University Cancer Hospital, Chongqing, China

BACKGROUND: 99Tcm-MDP SPECT/CT is widely used to diagnose early bone metastasis. Ribs are high-risk bone metastasis sites, while few study is related to ribs. The study is to investigate the risk factors of rib metastases in lung cancer patients.
METHODS: We retrospectively analyzed the patients' clinical characteristics and SPECT/CT imaging features. The patients were divided into a rib metastasis group (108 cases) and a non-rib metastasis group (103 cases).
RESULTS: In 211 patients, rib metastases were closely related to tumor markers, T stage, N stage, clinical staging, lymph node involvement, number of rib foci, localization on rib and foci type (P < 0.05). In 93 patients with pure rib foci, rib metastases were affected by clinical staging, lymph node involvement, localization on the rib and primary lung cancer localization (P < 0.001, 0.038, < 0.001, 0.034, respectively). In 100 patients with a solitary rib focus, rib metastases were associated with clinical staging, localization on the rib, and lymph node involvement (P < 0.001, 0.001, and 0.014, respectively). In all 633 rib foci, localization on the rib was an effective risk factor for rib metastases (P < 0.001).
CONCLUSIONS: Patients with increased tumor markers, stage IV lung adenocarcinoma and multiple rib foci located ipsilaterally with the primary lung tumor, or rib foci accompanied other bone foci are more likely to develop rib metastasis. Patients with pure rib foci or a solitary rib focus, especially in the anterior rib with negative lymph node involvement, have a low probability of rib metastasis.

KEY WORDS: Lung cancer; Rib metastasis; Rib foci; SPECT/CT