Diagnostic & prognostic impact of 18F-NaF PET/CT versus 99mTc-MDP bone scan in detection of bone metastases: Initial and follow up assessment

Salma AbdelAziz  Badr; Hosna Moustafa; Walid  Omar; Ibrahim  Siddiq; Mai Amr  Elahmadawy

doi:10.53730/ijhs.v6nS9.13075

Authors

Salma AbdelAziz Badr
salma.badr@cu.edu.eg
Nuclear Medicine Unit, National Cancer Institute (NCI), Cairo University, Egypt.
Hosna Moustafa Professor of Nuclear Medicine, NEMROCK Centre, Faculty of Medicine, Cairo University, Egypt
Walid Omar Professor of Nuclear Medicine, National Cancer Institute (NCI), Cairo University, Egypt.
Ibrahim Siddiq Physicist, Cyclotron facilities, CCHE-57357, Egypt.
Mai Amr Elahmadawy Assistant professor of Nuclear Medicine, National Cancer Institute (NCI), Cairo University, Egypt.

Keywords:

Naf PET/CT, Bone metastases, 99mTc-MDP bone scans

Abstract

Purpose: To assess the role of ¹⁸F-NaF PET/CT in the detection of metastatic bone disease compared to ^99mTc-MDP bone scan (+/-SPECT/CT). Methods: 64 adult patients with locally advanced primary tumor were enrolled in this study. All patients underwent pretherapy ¹⁸F-NaF PET/CT and ^99mTc-MDP bone scan. Results: Among the 64 patients ¹⁸F-NaF PET/CT revealed positive bone metastases in 26 patients, only 19 of them have positive results in ^99mTc-MDP bone scan, while the remaining 7 patients were falsely negative in ^99mTc-MDP bone scan. On the other hand ¹⁸F-NaF PET/CT diagnosed 38 patients free of osseous metastases, 5 patients of them were falsely diagnosed having osseous metastases by ^99mTc-MDP bone scan. None of patient has positive bone metastases by ^99mTc-MDP & negative ¹⁸F-NaF PET/CT for bone metastases in our study group. The overall results revealed significant higher sensitivity for ¹⁸F-NaF PET/CT (100%) compared to ^99mTc-MDP bone scan (73.08%) (P<0.05) as well as higher specificity for ¹⁸F-NaF PET/CT (100%) compared to ^99mTc-MDP bone scan (86.8%) (P<0.05). Conclusion: 18F-NaF PET/CT is a high-quality skeletal imaging with convenient diagnostic performance in either lytic or sclerotic bone lesions surpassing that of Tc99m MDP, with lower equivocal interpretations.

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References

V. Cuccurullo et al., “Bone metastases radiopharmaceuticals: an overview.,” Curr. Radiopharm., vol. 6, no. 1, pp. 41–47, Mar. 2013.

L. Zhang et al., “A comparative study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and (99m)Tc-MDP whole-body bone scanning for imaging osteolytic bone metastases.,” BMC Med. Imaging, vol. 15, p. 7, Mar. 2015.

E. Dyrberg et al., “(68)Ga-PSMA-PET/CT in comparison with (18)F-fluoride-PET/CT and whole-body MRI for the detection of bone metastases in patients with prostate cancer: a prospective diagnostic accuracy study.,” Eur. Radiol., vol. 29, no. 3, pp. 1221–1230, Mar. 2019.

I. F. Gareen et al., “Hospice Admission and Survival After (18)F-Fluoride PET Performed for Evaluation of Osseous Metastatic Disease in the National Oncologic PET Registry,” J. Nucl. Med., vol. 59, no. 3, pp. 427–433, Mar. 2018.

U. Tateishi, S. Morita, and T. Inoue, “Diagnostic accuracy of 18F-fluoride PET and PET/CT in patients with bone metastases: a systematic review and meta-analysis update,” Clin. Transl. Imaging, vol. 1, no. 2, pp. 123–134, Apr. 2013.

R. Kumar Kulshrestha et al., “The Role of 18 F-Sodium Fluoride PET/CT Bone Scans in the Diagnosis of Metastatic Bone Disease from Breast and Prostate Cancer,” 2016.

E. Even-Sapir et al., “The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP Planar bone scintigraphy, single- and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT.,” J. Nucl. Med., vol. 47, no. 2, pp. 287–97, Feb. 2006.

M. Hetzel et al., “F-18 NaF PET for Detection of Bone Metastases in Lung Cancer: Accuracy, Cost-Effectiveness, and Impact on Patient Management,” J. Bone Miner. Res., vol. 18, no. 12, pp. 2206–2214, Dec. 2003.

N. A. Damle et al., “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.,” Jpn. J. Radiol., vol. 31, no. 4, pp. 262–269, Apr. 2013.

Y. Liu et al., “The diagnostic performance of 18F-fluoride PET/CT in bone metastases detection: a meta-analysis,” Clin. Radiol., vol. 74, no. 3, pp. 196–206, Mar. 2019.

P. Lapa et al., “The value of quantitative analysis in (18)F-NaF PET/CT.,” Rev. Esp. Med. Nucl. Imagen Mol., vol. 36, no. 2, pp. 78–84, Mar. 2017.

S. Lindgren Belal et al., “3D skeletal uptake of (18)F sodium fluoride in PET/CT images is associated with overall survival in patients with prostate cancer.,” EJNMMI Res., vol. 7, no. 1, p. 15, Dec. 2017.