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Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[18F] F and [18F]FDG: a Focus on Skeletal Lesions

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Abstract

Purpose

The purpose of this study is to prospectively evaluate the performance of sodium 18F]fluoride (Na[18F]F)/2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) simultaneous time-of-flight enabled positron emission tomography (PET)/magnetic resonance imaging (MRI) for the detection of skeletal metastases in selected patients with advanced breast and prostate cancers.

Procedure

The institutional review board approved this HIPAA-compliant protocol. Written informed consent was obtained from each patient. A total of 74 patients (23 women and 51 men with breast and prostate cancer, respectively) referred for standard-of-care whole-body bone scintigraphy (WBBS) were enrolled in this prospective study. All patients underwent a [99mTc]methyldiphosphonate ([99mTc]MDP) WBBS followed by Na[18F]F/[18F]FDG PET/MRI. Lesions detected by each imaging modality were tabulated and a lesion-based and patient-based analysis was conducted.

Results

On a patient-based analysis, [99mTc]MDP WBBS identified skeletal lesions in 37 patients and PET/MRI in 45 patients. On a lesion-based analysis, WBBS identified a total of 81 skeletal lesions, whereas PET/MRI identified 140 lesions. Additionally, PET/MRI showed extra-skeletal lesions in 19 patients, including lymph nodes (16), prostate (4) lung (3), and liver (2) lesions.

Conclusions

The ability of Na[18F]F/[18F]FDG PET/MRI to identify more skeletal lesions than 99mTc-MDP WBBS and to additionally identify extra-skeletal disease may be beneficial for patient care and represent an alternative to the single modalities performed separately. Na[18F]F/[18F]FDG PET/MRI is a promising approach for evaluation of skeletal and extra-skeletal lesions in a selected population of breast and prostate cancer patients.

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Acknowledgments

We thank Negin Hatami, MD, Praveen Gulaka, PhD, our technologists Dawn Holley and Harsh Gandhi for their technical assistance, as well as our clinical coordinators. A special thank you is extended to all the patients who agreed to participate in the study and their families.

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Authors and Affiliations

  1. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA, 94305, USA

    Ida Sonni, Ryogo Minamimoto, Lucia Baratto & Andrei Iagaru

  2. Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, CA, USA

    Sanjiv S. Gambhir & Andreas M. Loening

  3. Division of Body MRI, Department of Radiology, Stanford University, Stanford, CA, USA

    Andreas M. Loening & Shreyas S. Vasanawala

  4. Radiological Science Laboratory, Department of Radiology, Stanford University, Stanford, CA, USA

    Shreyas S. Vasanawala

Authors
  1. Ida Sonni
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  2. Ryogo Minamimoto
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  3. Lucia Baratto
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  4. Sanjiv S. Gambhir
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  5. Andreas M. Loening
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  6. Shreyas S. Vasanawala
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  7. Andrei Iagaru
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Corresponding author

Correspondence to Andrei Iagaru.

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Conflict of Interest

This study was funded by GE Healthcare. Ida Sonni, Ryogo Minamimoto, Lucia Baratto, Negin Hatami have no conflict of interest. Sanjiv Gambhir, Andrei Iagaru, Andreas Loening and Shreyas Vasanawala received institutional research grants from GE Healthcare.

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Sonni, I., Minamimoto, R., Baratto, L. et al. Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[18F] F and [18F]FDG: a Focus on Skeletal Lesions. Mol Imaging Biol 22, 397–406 (2020). https://doi.org/10.1007/s11307-019-01392-9

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  • DOI: https://doi.org/10.1007/s11307-019-01392-9

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