COMPARISON BETWEEN COMPUTED TOMOGRAPY AND BONE SCINTIGRAPHY FOR EVALUTION OF BONE METASTASES FROM BREAST CANCER.

Abstract

Background: Breast cancer is a leading malignancy among women worldwide, frequently metastasizing to the bones, leading to significant morbidity. Accurate detection of bone metastases is crucial for optimal management and treatment decisions. Computed tomography (CT) and bone scintigraphy (BS) are widely used imaging modalities, each with distinct advantages. While CT provides detailed structural visualization, BS offers higher sensitivity in detecting early metastatic involvement. This study aimed to compare the diagnostic accuracies of CT and BS in detecting bone metastases in breast cancer patients.

Objective: To assess the prevalence and severity of breast cancer bone metastases using CT and BS across different age groups and determine the most effective imaging modality for early detection.

Methods: A descriptive cross-sectional study was conducted at the Institute of Nuclear Medicine & Oncology Lahore (INMOL) Hospital, including 158 female participants recruited through purposive sampling. Participants were stratified into three age groups: 30–45 years, 45–60 years, and above 60 years. Clinical symptoms, CT findings, and BS findings were analyzed over four months. CT scans assessed bone metastases, lesion characteristics, and breast tissue abnormalities, while BS evaluated osteoblastic and osteolytic changes. Chi-square analysis was performed to determine associations between clinical symptoms and imaging findings.

Results: Among 158 participants, 58 (36.7%) were aged 30–45 years, 80 (50.6%) were 45–60 years, and 20 (12.7%) were above 60 years. Bone metastases were detected in 66 (41.8%) participants on BS and in 59 (37.3%) on CT. Osteoblastic changes were identified in 92 (58.2%), osteolytic changes in 69 (43.7%), and abnormal tracer uptake in 66 (41.8%) participants. CT imaging revealed breast abnormalities in 100 (63.3%) participants, with heterogeneous lobulated masses being the most common finding. Chi-square analysis demonstrated a statistically significant correlation between bone pain and metastatic involvement (p < 0.001).

Conclusion: Bone scintigraphy demonstrated superior sensitivity in detecting bone metastases compared to CT, suggesting its utility as the preferred initial imaging modality for breast cancer patients with suspected skeletal involvement. Incorporating both modalities in a multimodal diagnostic approach can enhance early detection and improve patient outcomes.