RT Journal Article
SR Electronic
T1 Imaging Patients with Breast and Prostate Cancers Using Combined <sup>18</sup>F NaF/<sup>18</sup>F FDG and TOF simultaneous PET/ MRI
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 755
OP 755
VO 58
IS supplement 1
A1 Sonni, Ida
A1 Minamimoto, Ryogo
A1 Taviani, Valentina
A1 HATAMI, NEGIN
A1 Gambhir, Sanjiv
A1 Vasanawala, Shreyas
A1 Iagaru, Andrei
YR 2017
UL http://jnm.snmjournals.org/content/58/supplement_1/755.abstract
AB 755Objectives: We have already reported that the simultaneous injection of 18F-NaF and 18F-FDG can be successfully used in the evaluation of different cancer patients. The purpose of our study was to prospectively compare the combined 18F-NaF/18F-FDG, using a simultaneous PET/ MRI scanner with TOF capability, against 99mTc-MDP bone scan, in patients with breast and prostate cancers for the detection of metastatic disease.Methods: Fifty-six patients referred for 99mTc-MDP bone scan were prospectively enrolled from Oct 14 to December 2016. The cohort included 39 men with prostate cancer and 17 women with breast cancer, 34 - 85 year-old (mean: 64 ± 11). 18F-NaF (0.7-2.2 mCi, mean: 1.1 mCi ± 0.2) and 18F FDG (3.6-5.5 mCi, mean: 4.1 mCi ± 0.3) were subsequently injected from separate syringes. The PET/MRI was done 4-30 days (average 18 ± 8.4) after bone scan. The whole-body MRI protocol consisted of T2-weighted, DWI, and contrast-enhanced T1-weighted imaging. Lesions detected with each test were tabulated and the results were compared.Results: All patients tolerated the PET/MRI exam, and PET image quality was diagnostic despite the marked reduction in the administered dosage of radiopharmaceuticals (80% less for 18F-NaF and 67% less for 18F-FDG compared to standard protocols). Twenty-nine had no bone metastases identified on either scans. Bone scintigraphy and PET/MRI showed osseous metastases in 22 patients, but more numerous bone findings were noted on PET/MRI than on bone scintigraphy in 14 patients, while one more lesion was identified by bone scan in one patient. One patient had no bone lesions on PET/MRI, but one lesion was identified by bone scan. Four patients had negative bone scans, but bone metastases were seen on PET/MRI. Lesions outside the skeleton (lymph nodes, prostate and lung lesions) were identified by PET/MRI in 10 patients.Conclusion: The combined 18F-NaF/18F-FDG PET/MRI is superior to 99mTc-MDP scintigraphy for evaluation of skeletal disease extent. Further, it detected extra-skeletal disease that may change the management of these patients, while allowing a significant reduction in radiation exposure from lower dosages of PET radiopharmaceuticals administered. A combination of 18F-NaF/18F-FDG PET/MRI may provide the most accurate staging of patients with breast and prostate cancers prior to the start of treatment. Research Support: GE Healthcare