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Treatment Response Assessment of Skeletal Metastases in Prostate Cancer with 18F-NaF PET/CT

Nuclear Medicine and Molecular Imaging volume 53, pages 247–252 (2019)Cite this article

Abstract

Purpose

To determine the utility of 18F-sodium fluoride positron emission tomography-computed tomography (18F-NaF PET/CT) in the imaging assessment of therapy response in men with osseous-only metastatic prostate cancer.

Methods

In this Institutional Review Board–approved single institution retrospective investigation, we evaluated 21 18F-NaF PET/CT scans performed in 14 patients with osseous metastatic disease from prostate cancer and no evidence of locally recurrent or soft-tissue metastatic disease who received chemohormonal therapy. Imaging-based qualitative and semi-quantitative parameters were defined and compared with changes in serum PSA level.

Results

Qualitative and semi-quantitative image-based assessments demonstrated > 80% concordance with good correlation (SUVmax κ = 0.71, SUVavg κ = 0.62, SUVsum κ = 0.62). Moderate correlation (κ = 0.43) was found between SUVmax and PSA-based treatment response assessments. There was no statistically significant correlation between PSA-based disease progression and semi-quantitative parameters. Qualitative imaging assessment was moderately correlated (κ = 0.52) with PSA in distinguishing responders and non-responders.

Conclusion

18F-NaF PET/CT is complementary to biochemical monitoring in patients with bone-only metastases from prostate cancer which can be helpful in subsequent treatment management decisions.

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Fig. 1
Fig. 2

Abbreviations

CT:

computed tomography

PET:

positron emission tomography

PSA:

prostate-specific antigen

MDP:

methylene diphosphonate

NaF:

sodium fluoride

P:

progressor

NP:

non-progressor

R:

responder

NR:

non-responder

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Funding

We acknowledge National Institutes of Health grants R01-CA111613 (PI: H. Jadvar) and P30-CA014089 (USC Norris Comprehensive Cancer Center).

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Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, 2250 Alcazar St., CSC 102, Los Angeles, CA, 90033, USA

    Erik M. Velez, Bhushan Desai & Hossein Jadvar

Authors
  1. Erik M. Velez
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  2. Bhushan Desai
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  3. Hossein Jadvar
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Corresponding author

Correspondence to Hossein Jadvar.

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Conflict of Interest

Erik M. Velez, Bhushan Desai, and Hossein Jadvar declare no conflicts of interest. There was no direct funding for this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Velez, E.M., Desai, B. & Jadvar, H. Treatment Response Assessment of Skeletal Metastases in Prostate Cancer with 18F-NaF PET/CT. Nucl Med Mol Imaging 53, 247–252 (2019). https://doi.org/10.1007/s13139-019-00601-1

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  • DOI: https://doi.org/10.1007/s13139-019-00601-1

Keywords

  • 18F-NaF
  • PET/CT
  • Prostate
  • Cancer
  • Metastasis
  • Bone