Objective To evaluate the feasibility of whole body diffusion weighted imaging （DWI） in bone metastasis detection using bone scintigraphy as comparison. Methods Forty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance （MR） examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians

who were blinded to the results of the other imaging modality. The sensitivity

specificity

positive predictive value （PPV） and negative predictive value （NPV） of the two techniques for detecting bone metastasis were analyzed. Results A total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI

and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar （89.5% vs. 81.6%

97.1% vs. 91.2%）

whereas

the patient-based specificity and NPV of whole body DWI were obviously higher than those of bone scintigraphy （85.7% vs. 57.1%

60.0% vs. 36.4%）. Ten regions negative in scintigraphy but positive in whole body DWI

mainly located in spine

pelvis

and femur; nine regions only detected by scintigraphy

mainly located in skull

sternum

clavicle

and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy （89.5% vs. 88.4%

95.6% vs. 87.6%）. Conclusion Whole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis

and the two techniques are complementary for each other.