Usefulness of 18F-fluoride PET/CT in Breast Cancer Patients with Osteosclerotic Bone Metastases |
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Authors: | Seok-Ho Yoon Ku Sang Kim Seok Yun Kang Hee-Sung Song Kyung Sook Jo Bong-Hoi Choi Su Jin Lee Joon-Kee Yoon Young-Sil An |
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Institution: | 1. Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721 2. Department of Surgery, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721 3. Department of Hematology-Oncology, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721 4. Clinical Research Institute, Gyeongsang National University Hospital, Chiram-dong, Jinju Si, Gyeongsangnam-Do, Republic of Korea, 660-702
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Abstract: | Purpose Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole-body bone scintigraphy (WBBS) can evaluate skeletal metastases, and 18F-FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of 18F-FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that 18F-fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of 18F-fluoride PET/CT by comparing it with WBBS and 18F-FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases. Materials and Methods Nine breast cancer patients with suspected bone metastases (9 females; mean age ± SD, 55.6 ± 10.0 years) underwent 99mTc-MDP WBBS, 18F-FDG PET/CT and 18F-fluoride PET/CT. Lesion-based analysis of five regions of the skeletons (skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient-based analysis were performed. Results 18F-fluoride PET/CT, 18F-FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of 18F-fluoride PET/CT were 94.2 %, 46.3 %, 57.7 % and 91.2 %, respectively. Most true metastatic lesions on 18F-fluoride PET/CT had osteosclerotic change (45/49, 91.8 %), and only four lesions showed osteolytic change. Most lesions on 18F-FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0 %) with three osteolytic lesions. All true metastatic lesions detected on WBBS and 18F-FDG PET/CT were identified on 18F-fluoride PET/CT. Conclusion 18F-fluoride PET/CT is superior to WBBS or 18F-FDG PET/CT in detecting osteosclerotic metastatic lesions. 18F-fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients. |
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Keywords: | 18F-fluoride 18F-NaF PET/CT Breast cancer Skeletal metastases |
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