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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Withofs, N. Articles by Hustinx, R. PubMed Articles by Withofs, N. Articles by Hustinx, R.

18F-Fluoride PET/CT for assessing bone involvement in prostate and breast cancer

¹ University Hospital of Liège, Liège, Belgium

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Objectives: To evaluate the accuracy of 18F-fluoride PET/CT for detecting bone metastases in patients with breast or prostate cancer, using full diagnostic CT or MRI as gold standard.

Methods: We prospectively included 47 pts with breast (N= 31) or prostate (N=16) cancer and clinical (bone pain) or biological (PSA or CA 15-3) suspicion of metastatic disease. Whole-body PET/ CT (PET:1 to 2 min. per bed position, low-dose CT) was acquired 45 min. after injecting 300 MBq 18F- fluoride. Bone scintigraphies (BS, n=47, including 33 with SPECT) were obtained using a dual-head camera. Each dataset (PET and BS) was interpreted blindly and separately. All foci were recorded and classified as malignant, equivocal or benign. Thin-slice CT or MRI were then performed and blindly read by an experimented radiologist.

Results: Out of 810 foci detected by PET/CT and/or BS, 498 (61.5%) could be verified by CT or MRI, with a final diagnosis of 304 metastases and 194 benign lesions. In breast cancer, considering equivocal foci as benign, the sensitivity was 78.3% for PET/CT and 37.4% for BS with specificity of 69.6% and 75.4%, respectively. For lytic lesions only, the sensitivity was 50% and 23.3%. PET/CT was particularly sensitive for pelvic and thoracic localizations. In prostate cancer, the sensitivity and specificity were 100% and 93.2% for PET/CT and 66.7% and 91.7% for BS. All lesions considered the accuracy was 78.7% for PET/CT and 55.4% for BS. PET/CT provided a correct diagnosis (M+/M0) in 45/47 pts (96%, 2 FP), as compared to 37/47 with BS (79%, 6 FP, 4 FN).

Conclusions: 18F-Fluoride PET/CT is more accurate than 99mTc-MDP BS for detecting bone metastases from prostate and breast cancer. Our lower sensitivity for PET/CT, compared to the literature, is probably due to a more stringent gold standard.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Withofs, N. Articles by Hustinx, R. PubMed Articles by Withofs, N. Articles by Hustinx, R.