| Institution: | (1) Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;(2) Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;(3) Department of Radiology, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;(4) Department of Nuclear Medicine, Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands |
| Abstract: | Distant metastases from breast cancer most frequently occur in the skeleton. Although 18F-fluorodeoxyglucose (FDG) positron
emission tomography (PET), with or without computed tomography (CT), is superior to bone scintigraphy for the detection of
osteolytic bone metastases, it has been reported that sclerotic bone metastases frequently show no or only a low degree of
FDG uptake on PET and PET/CT. Since both lytic and sclerotic metastases can occur in breast cancer patients, bone scintigraphy
may remain of additional value in these patients. In this case series, we describe four breast cancer patients in whom FDG
PET/CT has clearly visualized sclerotic bone metastases because of increased FDG uptake. Not so much the type of metastasis
(sclerotic or lytic), but possibly the characteristics of the primary tumor or treatments prior to the FDG PET/CT scan might
influence the degree of FDG uptake of bone metastases. The ability to detect sclerotic bone metastases based on increased
FDG uptake supports the use of FDG PET/CT as a staging procedure in breast cancer patients, but knowledge of factors determining
the visibility of bone metastases with FDG PET/CT is crucial. |
