RT Journal Article
SR Electronic
T1 Prospective Comparison of <sup>99m</sup>Tc-MDP Scintigraphy, Combined <sup>18</sup>F-NaF and <sup>18</sup>F-FDG PET/CT, and Whole-Body MRI in Patients with Breast and Prostate Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1862
OP 1868
DO 10.2967/jnumed.115.162610
VO 56
IS 12
A1 Ryogo Minamimoto
A1 Andreas Loening
A1 Mehran Jamali
A1 Amir Barkhodari
A1 Camila Mosci
A1 Tatianie Jackson
A1 Piotr Obara
A1 Valentina Taviani
A1 Sanjiv Sam Gambhir
A1 Shreyas Vasanawala
A1 Andrei Iagaru
YR 2015
UL http://jnm.snmjournals.org/content/56/12/1862.abstract
AB We prospectively evaluated the use of combined 18F-NaF/18F-FDG PET/CT in patients with breast and prostate cancer and compared the results with those for 99mTc-MDP bone scintigraphy and whole-body MRI. Methods: Thirty patients (15 women with breast cancer and 15 men with prostate cancer) referred for standard-of-care bone scintigraphy were prospectively enrolled in this study. 18F-NaF/18F-FDG PET/CT and whole-body MRI were performed after bone scintigraphy. The whole-body MRI protocol consisted of both unenhanced and contrast-enhanced sequences. Lesions detected with each test were tabulated, and the results were compared. Results: For extraskeletal lesions, 18F-NaF/18F-FDG PET/CT and whole-body MRI had no statistically significant differences in sensitivity (92.9% vs. 92.9%, P = 1.00), positive predictive value (81.3% vs. 86.7%, P = 0.68), or accuracy (76.5% vs. 82.4%, P = 0.56). However, 18F-NaF/18F-FDG PET/CT showed significantly higher sensitivity and accuracy than whole-body MRI (96.2% vs. 81.4%, P &lt; 0.001, 89.8% vs. 74.7%, P = 0.01) and bone scintigraphy (96.2% vs. 64.6%, P &lt; 0.001, 89.8% vs. 65.9%, P &lt; 0.001) for the detection of skeletal lesions. Overall, 18F-NaF/18F-FDG PET/CT showed higher sensitivity and accuracy than whole-body MRI (95.7% vs. 83.3%, P &lt; 0.002, 87.6% vs. 76.0%, P &lt; 0.02) but not statistically significantly so when compared with a combination of whole-body MRI and bone scintigraphy (95.7% vs. 91.6%, P = 0.17, 87.6% vs. 83.0%, P = 0.53). 18F-NaF/18F-FDG PET/CT showed no significant difference from a combination of 18F-NaF/18F-FDG PET/CT and whole-body MRI. No statistically significant differences in positive predictive value were noted among the 3 examinations. Conclusion: 18F-NaF/18F-FDG PET/CT is superior to whole-body MRI and 99mTc-MDP scintigraphy for evaluation of skeletal disease extent. Further, 18F-NaF/18F-FDG PET/CT and whole-body MRI detected extraskeletal disease that may change the management of these patients. 18F-NaF/18F-FDG PET/CT provides diagnostic ability similar to that of a combination of whole-body MRI and bone scintigraphy in patients with breast and prostate cancer. Larger cohorts are needed to confirm these preliminary findings, ideally using the newly introduced simultaneous PET/MRI scanners.