Evidence table 8: Accuracy of bone scintigraphy and SPECT for staging lung cancer. Reference Study type Patients Prevalence Index test Reference test (95% CI) Sensitivity % (95% CI) - PDF Document

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  1. Evidence table 8: Accuracy of bone scintigraphy and SPECT for staging lung cancer. Reference Study type Patients Prevalence Index test Reference test (95% CI) Sensitivity % (95% CI) Specificity % (95% CI) PPV % (95% CI) NPV % Test Accuracy study quality reported findings) / Comments (incl. other Hetzel (2003) J Bone & Mineral Researc h 18, 2206-14 Kahn (2004) Chest 125, 494-501 Prosp ective N = 103 w/ LC Bone metast asis: 33/103 Bone scintigraphy SPECT All availabl e imaging 60.6 98.6 95.2 84.1 86.4 Moderate quality Inconclusive results counted as errors Bone scintigraphy 51.5 94.3 81 80.5 80.6 99mTc depreotide SPECT Prosp ective N = 128 w/ suspected resectable LC N- staging N0: N = 97 N1: N = 6 N2: N = 19 N3: N = 6 N- staging N0: N = 35 N2: N = 13 N3: N = 2 Histopa thology /follow up 68 (48- 83) 70 (60- 79) 42 (29- 57) 87 (77- 93) Low quality 201T1-chloride SPECT Demura (2003) J Nuclear Med 44, 540-48 Prosp ective N = 50 Surgical resecti on/ follow up/ biopsy 53.3 77.1 50 79 70 Moderate quality

  2. 99mTc- Tetrofosmin SPECT Schillaci (2003) J Nucl Med 44, 1219- 1224 Song (2009) Lung Cancer, 65, 333- 8 Takenak a (2009) J MRI, 30, 298- 308 Prosp ective N = 83 w/ NSCLC and no distant metastases N- staging: 35/83 Medias tinosco py/thor acotom y 85.7 89.6 85.7 89.6 88 Moderate quality Retros pectiv e N = 1000 w/ NSCLC Bone metast asis: 105/10 00 Bone scintigraphy Biopsy/ imaging /follow up 78.1 97.4 75.9 97.4 95.1 Low quality Prosp ective N = 115 w/ NSCLC Bone metast asis: 25/115 Bone scintigraphy Consen sus based on biopsy/ imaging /follow up Follow up 96 (79.7- 99.9) 83.3 (74- 90.4) 61.5 (44.6 - 76.6) 98.7 (92.9- 100) 86.1 (78.4- 91.8) Moderate quality Cheran (2004) Lung Cancer 44, 317- 25 Retros pectiv e N = 257 w/ LC Bone- metast asis: Yes: N = 57 No: N = 200 Bone scintigraphy (BS) Equivocal findings = positive for bone mets 75 (62- 86) 95) (59- 83) Equivocal findings = negative for bone mets 63 (49- 76) 98) (64- 89) Low quality 92 (87- 72 93 (88- 96) 88 95 (91- 78 90 (85- 94) 88