Abstract
This study aimed to evaluate the diagnostic efficacy of 68Ga-labeled DOTA-ibandronic acid positron emission tomography/computed tomography (68Ga-DOTA-IBA PET/CT) and 99mTc-labelled methylene diphosphonate (99mTc-MDP) bone scintigraphy (BS) in detecting bone metastases. Patients who underwent both 99mTc-MDP bone scintigraphy and ⁶⁸Ga-DOTA-IBA PET/CT within a one-week interval between March 2022 and April 2024 were retrospectively enrolled in this study. A total of 133 patients (67 males and 66 females; age: 59.98 ± 12.58) were included. The resulting images were subsequently analyzed by seasoned nuclear medicine specialists. Diagnostic efficacy was assessed based on the detection rates of bone metastatic lesions by the two imaging modalities. The maximum standardized uptake values (SUVmax) of metastatic and benign bone lesions identified on ⁶⁸Ga-DOTA-IBA PET/CT were recorded to evaluate the diagnostic performance of ⁶⁸Ga-DOTA-IBA in differentiating malignant from benign bone lesions. A total of 1453 lesions were identified as bone metastases, with 1423 (97.9%) detected using 68Ga-DOTA-IBA PET/CT, and with 1208 lesions (83.1%) identified through optional SPECT-assisted 99mTc-MDP bone scintigraphy (p < 0.001). At the individual patient level, the detection rates of bone metastases using ⁶⁸Ga-DOTA-IBA PET/CT and SPECT-assisted 99mTc-MDP bone scintigraphy were both 132 out of 133 (99.2%), with no statistically significant difference observed. The SUVmax for malignant lesions was markedly higher than that observed in benign lesions (7.18(5.18 ~ 10.59) vs. 2.6(2.0 ~ 3.3), p < 0.001). The area under the curve (AUC) for SUVmax when diagnosing bone metastases with 68Ga-DOTA-IBA PET/CT was 0.958, utilizing a threshold of 4.0 to differentiate between benign and malignant lesions. 68Ga-DOTA-IBA PET/CT has a higher detection rate for skeletal metastases than SPECT-assisted 99mTc-MDP bone scintigraphy. Furthermore, ⁶⁸Ga-DOTA-IBA PET/CT has demonstrated a strong ability to differentiate between benign and malignant bone lesions.
Data availability
The datasets we used during the current study are not publicly available due to privacy issues, but are available from the corresponding author on reasonable request.
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Acknowledgements
We are grateful to the members of the Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University, and Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province for their technical guidance, cooperation, and assistance in completing this study. We are also grateful for the financial support given by the major science and technology project in Gansu Province (23ZDFA014) and the school-level scientific research project of Southwest Medical University (Grant No. 2024ZKY082).
Funding
This work was supported by the major science and technology project in Gansu Province (23ZDFA014) and the school-level scientific research project of Southwest Medical University (Grant No. 2024ZKY082).
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Xinyi Lin, Na Zhang, Tingting Xu, and Yue Chen contributed to the study design, and Xinyi Lin wrote the manuscript. Xinyi Lin, Na Zhang, Rongliang Wang, Huajun Liu, and Wei Wang collected the clinical data of patients. Xinyi Lin and Na Zhang analyzed the clinical data of patients. Yue Chen and Tingting Xu were responsible for revising important intellectual content. Yue Chen and Tingting Xu contributed equally to this paper and shared joint corresponding authorship. All authors read and approved the final manuscript. All authors read and approved the final manuscript.
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Lin, X., Zhang, N., Wang, R. et al. The performance of 68Ga-DOTA-IBA PET/CT for detecting bone metastases compared with 99mTc-MDP bone scintigraphy. Sci Rep (2026). https://doi.org/10.1038/s41598-026-40411-y
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DOI: https://doi.org/10.1038/s41598-026-40411-y
