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J Nucl Med. 2008; 49 (Supplement 1):375P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Negative F-18 Fluoride PET in malignant sclerotic bone lesions: Therapeutic effect, apoptosis, false negative?

Mohsen Beheshti1, Reza Vali1, Sigrid Poecher1, Michael Nader1, Peter Waldenberger2, Friedrich Fitz1, Ignac Fogelman3 and Werner Langsteger1

1 Nuclear Medicine & Endocrinology, PET-CT Center Linz; 2 Radiology, St. Vincent's Hospital, Linz, Austria; 3 Nuclear Medicine, Guy's Hospital, London, United Kingdom

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Objectives: F-18 Fluoride PET proved to be a highly sensitive method for detection of malignant bone disease. However, albeit it’s high sensitivity, there are some malignant bone lesions without F-18 Fluoride uptake. The aim of this study was to open a discussion for further clarification of F-18 Fluoride PET negative malignant sclerotic lesions.

Methods: Fourteen patients with known or suspected bone metastases were evaluated retrospectively. Two patients underwent whole body F-18 Fluoride PET-CT for preoperative staging and 12 patients for follow-up evaluation (10 patients with prostate cancer, 2 patients breast cancer, 1 patient squamous cell cancer in the mandible and 1 patient with cancer of unknown origin).

Results: Thirty one densely sclerotic lesions were detected on CT which were negative on F-18 Fluoride PET-CT. Mean density of sclerotic lesions by Hounsfield unit was 1221 +- 560. In retrospective monitoring, 5 lesions were positive in previous F-18 Fluoride PET studies. These F-18 Fluoride negative lesions remained negative in spite of diseases progression and new metastatic bone formations in the other sites of skeleton. Twenty seven F-18 Fluoride PET negative/ malignant sclerotic lesions (27/31) were detected in patients with previous therapy and 4 lesions (4/31) were seen in a patient without previous therapy.

Conclusions: F-18 Fluoride PET could be also negative in the highly dense malignant sclerotic lesions. This may be due to therapy response (in post therapeutic evaluation) or apoptosis (in patients without previous therapy) or false negative F-18 Fluoride PET. Nevertheless, this issue needs further clarification.





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Right arrow Articles by Beheshti, M.
Right arrow Articles by Langsteger, W.