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Usefulness of 18F-fluoride PET/CT in Breast Cancer Patients with Osteosclerotic Bone Metastases

Nuclear Medicine and Molecular Imaging volume 47, pages 27–35 (2013)Cite this article

Abstract

Purpose

Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole-body bone scintigraphy (WBBS) can evaluate skeletal metastases, and 18F-FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of 18F-FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that 18F-fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of 18F-fluoride PET/CT by comparing it with WBBS and 18F-FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases.

Materials and Methods

Nine breast cancer patients with suspected bone metastases (9 females; mean age ± SD, 55.6 ± 10.0 years) underwent 99mTc-MDP WBBS, 18F-FDG PET/CT and 18F-fluoride PET/CT. Lesion-based analysis of five regions of the skeletons (skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient-based analysis were performed.

Results

18F-fluoride PET/CT, 18F-FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of 18F-fluoride PET/CT were 94.2 %, 46.3 %, 57.7 % and 91.2 %, respectively. Most true metastatic lesions on 18F-fluoride PET/CT had osteosclerotic change (45/49, 91.8 %), and only four lesions showed osteolytic change. Most lesions on 18F-FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0 %) with three osteolytic lesions. All true metastatic lesions detected on WBBS and 18F-FDG PET/CT were identified on 18F-fluoride PET/CT.

Conclusion

18F-fluoride PET/CT is superior to WBBS or 18F-FDG PET/CT in detecting osteosclerotic metastatic lesions. 18F-fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721

    Seok-Ho Yoon, Hee-Sung Song, Kyung Sook Jo, Su Jin Lee, Joon-Kee Yoon & Young-Sil An

  2. Department of Surgery, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721

    Ku Sang Kim

  3. Department of Hematology-Oncology, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Kyunggi-do, Republic of Korea, 443-721

    Seok Yun Kang

  4. Clinical Research Institute, Gyeongsang National University Hospital, Chiram-dong, Jinju Si, Gyeongsangnam-Do, Republic of Korea, 660-702

    Bong-Hoi Choi

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  1. Seok-Ho Yoon
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Correspondence to Young-Sil An.

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Yoon, SH., Kim, K.S., Kang, S.Y. et al. Usefulness of 18F-fluoride PET/CT in Breast Cancer Patients with Osteosclerotic Bone Metastases. Nucl Med Mol Imaging 47, 27–35 (2013). https://doi.org/10.1007/s13139-012-0178-0

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  • DOI: https://doi.org/10.1007/s13139-012-0178-0

Keywords

  • 18F-fluoride
  • 18F-NaF
  • PET/CT
  • Breast cancer
  • Skeletal metastases