PT  - JOURNAL ARTICLE
AU  - Marinos Drakopoulos
AU  - Kaveh Vejdani
AU  - Medhat Osman
TI  - Comparison of diagnostic certainty and accuracy of 18F-NaF PET/CT and planar 99mTc-MDP bone scan in patients with prostate cancer
DP  - 2014 May 01
TA  - Journal of Nuclear Medicine
PG  - 1669--1669
VI  - 55
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/55/supplement_1/1669.short
4100  - http://jnm.snmjournals.org/content/55/supplement_1/1669.full
SO  - J Nucl Med2014 May 01; 55
AB  - 1669 Objectives To compare the diagnostic certainty and accuracy of 18F-NaF PET/CT and planar 99mTc-MDP bone scan in patients with prostate cancer (P-Ca) with biochemical recurrence, as evidenced by a rise in serum prostate specific antigen (PSA) level. Methods 18F-NaF PET/CT and planar 99mTc-MDP bone scan images from 15 patients with known P-Ca were retrospectively reviewed. Each image was independently viewed and interpreted by an experienced nuclear medicine physician blinded to clinical information. A 5-point scale was used to characterize the diagnostic certainty of lesion interpretation (0= definitely benign, 1= probably benign, 2= equivocal, 3= probably malignant, 4= definitely malignant). Results The patients’ ages ranged from 42 to 95 years (mean ± SD, 68.5 ± 13 years). The serum PSA level ranged from 0.1 - 103 ng/mL (mean ± SD, 44.16 ± 38.8 ng/mL). Findings between 18F-NaF PET/CT and planar 99mTc-MDP were concordant in 40% (6/15) of the cases, discordant in 20% (3/15) and partially concordant in the remaining 40% (6/15). 18F-NaF PET/CT findings increased diagnostic certainty in 33% (5/15) of the cases. The confidence of interpretation increased from 60% (9/15) in 99mTc-MDP cases to 93.3% (14/15) in 18F-NaF PET/CT cases; thus decreasing the number of equivocal or probable cases from 40% (6/15) to 6.6% (1/15). Conclusions 18F-NaF PET/CT imaging increases the diagnostic certainty and accuracy of characterizing skeletal lesions from metastatic prostate cancer, as compared with planar 99mTc-MDP bone scan. More definitely normal or definitely abnormal lesions (and fewer probable and equivocal lesions) were identified with 18F-NaF PET/CT than with planar 99mTc-MDP bone scan. In patients with prostate cancer and biochemical recurrence, 18F-NaF PET/CT should be part of the clinical evaluation, particularly if planar 99m TC-MDP bone scan is negative.