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. 2018 Feb;52(1):62-68.
doi: 10.1007/s13139-017-0492-7. Epub 2017 Aug 29.

Multiple Regression Analysis of Predictors of Bone Scintigraphy Positivity in Patients with Head and Neck Cancers

Daris Theerakulpisut  1 , Nantaporn Wongsurawat  1 , Narudom Supakalin  2 , Charoonsak Somboonporn  1
Affiliations

Multiple Regression Analysis of Predictors of Bone Scintigraphy Positivity in Patients with Head and Neck Cancers

Daris Theerakulpisut et al. Nucl Med Mol Imaging. 2018 Feb.

Abstract

Purpose: The value of bone scintigraphy (BS) in patients with head and neck cancers (HNCs) has been questioned, with conflicting findings regarding positivity yield with some reports recommending BS be omitted from work-up of HNC patients since it rarely yields positive results. This study aims to determine the positivity yield of BS in HNCs and to determine predictors for BS positivity to help tailor appropriate BS utilization.

Methods: BS studies of HNC patients were reviewed, the positivity yield was determined. Clinical predictors for BS positivity including age, sex, site of cancer, staging, histological grading were analyzed using univariable and multivariable logistic regression.

Results: Among the 259 BS studies included, 35 (13.5%), 194 (74.9%), and 30 (11.6%) were positive, negative, and equivocal for bone metastasis, respectively. After exclusion of equivocal cases, 229 were analyzed in the regression models. Independent predictors of BS positivity include site of tumor at the nasopharynx (OR 4.37, 95% C.I. 1.04-18.41, p = 0.044), age less than 45 years (OR 3.01, 95% C.I. 1.24-7.33, p = 0.015), and presence of distant metastasis to other organs (OR 3.84, 95% C.I. 1.19-12.43, p = 0.025).

Conclusions: In contrast to several studies, bone metastasis as detected by BS was found in a relatively high proportion of patients with HNCs. Independent predictors of BS positivity include the age of less than 45 years, tumor site at the nasopharynx, and the presence of extraskeletal distant metastasis. BS could be useful in patients with these characteristics which enhance the pretest probability of bone metastasis.

Keywords: Bone metastasis; Bone scintigraphy; Head and neck cancers; Radionuclide imaging.

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Conflict of interest statement

Compliance with Ethical StandardsDaris Theerakulpisut, Nantaporn Wongsurawat, Narudom Supakalin, and Charoonsak Somboonporn, declare that they have no conflict of interest. No funding was received for conduction of this study.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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