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J Nucl Med. 2008; 49 (Supplement 1):341P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Detection of bone metastasis in breast cancer patients with FDG PET/CT

Henry Lin1, Mounir Mikhaeil1, Fransico Viejo-Rullan1, Ali Mosavi1 and Hussein Abdel-Dayem1

1 Saint Vincent's Hospital & Medical Center - Manhattan, East Brunswick, New Jersey

1442

Objectives: The role of FDG PET-CT vs. bone scan in detecting bone metastases is controversial. Most experts believe bone scans are better for detecting osteoblastic bone metastases whereas lytic lesions are better evaluated with FDG PET. This is presumably related to higher levels of FDG uptake by osteolytic lesions than blastic metastases. Skeletal metastases in patients with breast cancer can be characterized as osteoblastic, osteolytic, mixed or invisible on CT. The purpose of the study was to determine if there is any difference in level of FDG uptake among patients with osteoblastic vs. osteolytic lesions.

Methods: 494 PET-CT studies of patients with breast cancer were reviewed. 37 breast cancer patients with osseous metastatic disease were identified. 27% (10/37) demonstrated diffuse osseous metastatic disease (>10 lesions) and were excluded from further analysis. The authors retrospectively analyzed PET-CT scans of the reminding 27 patients (mean age:58.3 years old, range:30-87) referred for initial staging (n=1) and evaluation for recurrence (n=26) from breast carcinoma. Whole body PET/CT images were obtained with a PET/CT scanner (GE Discovery) 60-90 minutes after administration of 10-15 mCi FDG.

Results: PET/CT demonstrates a total of 48 osseous lesions as follows: 24 lytic, 22 osteoblastic, 1 mixed and 1 invisible lesion by CT. The maximum SUV of each lesion were measured. The SUV of the lytic, blastic, mixed and invisible lesions were 6.4±0.60, 4.2±0.30, 5.3, and 4.7 respectively. The max SUV uptake of lytic type (5.08±2.68) was statistically higher than blastic type (4.2±00.30, P<0.05).

Conclusions: FDG skeletal uptake is significantly higher in patients with osteolytic than osteoblastic lesions. Our data indicates that FDG PET/CT can prove valuable in detecting osseous metastatic disease.





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