The role of 18F-fluoride PET-CT in the detection of bone metastases in patients with breast, lung and prostate carcinoma: a comparison with FDG PET/CT and 99mTc-MDP bone scan

Damle, Nishikant Avinash ; Bal, Chandrasekhar ; Bandopadhyaya, G. P. ; Kumar, Lalit ; Kumar, Praveen ; Malhotra, Arun ; Lata, Sneh (2013) The role of 18F-fluoride PET-CT in the detection of bone metastases in patients with breast, lung and prostate carcinoma: a comparison with FDG PET/CT and 99mTc-MDP bone scan Japanese Journal of Radiology, 31 (4). pp. 262-269. ISSN 1867-1071

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Official URL: https://link.springer.com/article/10.1007%2Fs11604...

Related URL: http://dx.doi.org/10.1007/s11604-013-0179-7

Abstract

Objectives: We aimed to compare the role of 18F-fluoride PET/CT, FDG PET/CT and 99mTc-MDP bone scans in the detection of bone metastases in patients with lung, breast and prostate carcinoma. Methods: This was a prospective study including patients for staging (S) and restaging (R). Seventy-two patients (23S, 49R) with infiltrating ductal breast carcinoma, 49 patients (25S, 24R) with prostate adenocarcinoma and 30 patients (17S, 13R) with non-small-cell lung carcinoma (NSCLC), without known bone metastases but with high risk/clinical suspicion for the same, underwent a 99mTc-MDP bone scan, FDG PET/CT and 18F-fluoride PET/CT within 2 weeks. All scans were reviewed by two experienced nuclear medicine physicians, and the findings were correlated with MRI/thin-slice CT/skeletal survey. Histological verification was done wherever feasible. Results: Sensitivity and negative predictive value (NPV) of 18F-fluoride PET/CT was 100 % in all three malignancies, while that of FDG PET/CT was 79 % and 73 % in NSCLC, 73 % and 80 % in breast cancer and 72 and 65 % in prostate cancer. Specificity and positive predictive value (PPV) of FDG PET/CT were 100 % in NSCLC and prostate and 97 % and 96 % in breast cancer. As compared to the 99mTc-MDP bone scan, all parameters were superior for 18F-fluoride PET/CT in prostate and breast cancer, but sensitivity and NPV were equal in NSCLC. The MDP bone scan had superior sensitivity and NPV compared to FDG PET/CT but had low specificity and PPV. Conclusion: To rule out bone metastases in cases where there is a high index of suspicion, 18F-fluoride PET/CT is the most reliable investigation. 18F-fluoride PET/CT has the potential to replace the 99mTc-MDP bone scan for the detection of bone metastases.

Item Type:Article
Source:Copyright of this article belongs to Springer Verlag.
Keywords:Fluoride; FDG; PET/CT MDP; Bone Metastases
ID Code:111198
Deposited On:25 Sep 2017 12:42
Last Modified:25 Sep 2017 12:42

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