RT Journal Article SR Electronic T1 A prospective multicenter intra-individual comparison of 18F-NaF PET/CT and 99mTc-bone scintigraphy with SPECT for detection of skeletal metastases in high-risk prostate and breast cancer patients JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 2618 OP 2618 VO 63 IS supplement 2 A1 Benard, Francois A1 Harsini, Sara A1 Wilson, Don A1 Zukotynski, Katherine A1 Abikhzer, Gad A1 Turcotte, Eric A1 Cossette, Mariève A1 Metser, Ur A1 Romsa, Jonathan A1 Martin, Montgomery A1 Mar, Colin A1 Saad, Fred A1 Soucy, Jean-Paul A1 Black, Peter A1 Krauze, Andra A1 Burrell, Steven A1 Nichol, Alan A1 Tardif, Jean-Claude YR 2022 UL http://jnm.snmjournals.org/content/63/supplement_2/2618.abstract AB 2618 Introduction: Detection of skeletal metastases in prostate and breast cancer patients remains a major clinical challenge. This study aimed to compare the diagnostic performance of technetium methylene-diphosphonate single photon emission computed tomography (99mTc-MDP SPECT) and 18F-sodium fluoride positron emission tomography/computed tomography (18F-NaF PET/CT) for the detection of osseous metastases in patients with high-risk prostate or breast cancer.Methods: This prospective multicenter single-cohort study enrolled 288 participants diagnosed with high-risk breast (n=64) or prostate (n=224) cancer referred for evaluation of skeletal metastases. 18F-NaF PET/CT and 99mTc-MDP SPECT were subsequently performed within 14 days for each participant. Two independent reviewers interpreted each individual modality without knowledge of other imaging findings. Consensus reading, magnetic resonance imaging (MRI), and clinical and imaging follow-up for up to 24 months were used as reference methods.Results: 261 subjects underwent both 18F-NaF PET/CT and 99mTc-MDP SPECT and completed the required follow-up for statistical analysis. Based on the reference methods used, 41.8% of patients had bone metastases. In the patient-based analysis, 18F-NaF PET/CT was more accurate (84.3% vs. 77.4%, p=0.016) and more sensitive (78.9% vs. 63.3%, p=0.0007) than 99mTc-MDP SPECT. The negative predictive value was also higher for 18F-NaF PET/CT (85.4% for PET/CT vs. 76.9% for 99mTc-MDP SPECT, p=0.0006). Furthermore, according to the lesion-based analysis, 18F-NaF PET/CT detected a significantly greater number of lesions than 99mTc-MDP SPECT (p<0.0001). No adverse events occurred following 18F-NaF administration.Conclusions: In this prospective, blinded, intra-individual multicenter study of imaging for bone metastases in high-risk breast and prostate cancer patients, 18F-NaF PET/CT was more sensitive and accurate than 99mTc-MDP SPECT.