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J Nucl Med. 2008; 49 (Supplement 1):358P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

18F-Fluoride PET/CT may be more sensitive than 18F-FDG PET/CT for detecting skeletal metastasis in patients with primary nasopharyngeal carcinoma – An interim analysis

Feng-Yuan Liu1, Tzu-Chen Yen1, Joseph Chang2 and Hung-Ming Wang3

1 Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; 2 Department of Radiation Oncology; 3 Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan

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Objectives: 18F-FDG PET is more sensitive than traditional bone scan in the detection of skeletal metastasis in patients with primary nasopharyngeal carcinoma (NPC). The current study aimed to compare the diagnostic accuracy of 18F-fluoride PET/CT and 18F-FDG PET/CT in primary NPC patients with high risk or suspicious skeletal metastasis.

Methods: 18F-Fluoride PET/CT and 18F-FDG PET/CT were performed in 12 primary NPC patients with high risk or suspicious skeletal metastasis before initiation of treatment. The determination of presence or absence of skeletal metastasis was based on histopathology, correlation with diagnostic CT or MRI, or clinical and imaging follow-up of at least 6 mo.

Results: Six out of 12 patients were determined to have skeletal metastasis. Sensitivities of 18F-fluoride and 18F-FDG PET/CT were 100% and 67% respectively, while specificities were both 100%. Using the receiver-operating-characteristic (ROC) curve analysis, areas under the ROC curves for 18F-fluoride and 18F-FDG PET/CT were 1.00 and 0.83 respectively (P = 0.179). 18F-Fluoride PET/CT detected more metastatic lesions than 18F-FDG PET/CT. 18F-Fluoride PET/CT also detected more benign lesions which could be differentiated from metastatic lesions by utilizing morphological and localizational information provided by CT.

Conclusions: 18F-Fluoride PET/CT may be more sensitive and accurate than 18F-FDG PET/CT for detecting skeletal metastasis in primary NPC patients. More patients should be accrued in order to achieve statistically significant results.





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