Detection of metastatic bone lesions in breast cancer patients: Fused 18F-Fluoride-PET/MDCT has higher accuracy than MDCT. Preliminary experience

Arnoldo Piccardo, Vania Altrinetti, Lorenzo Bacigalupo, Matteo Puntoni, Ennio Biscaldi, Alberto Gozza, Manlio Cabria, Massimiliano Iacozzi, Ambra Pasa, Silvia Morbelli, Giampiero Villavecchia, Andrea Decensi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: So far, no studies comparing 18F-Fluoride-PET/CT and MDCT for the detection of bone metastases are available. We compared the accuracy of 18F-Fluoride-PET/CT (MDCT: 3.75 mm thickness-image- reconstruction), whole-body Multi-Detector-CT (MDCT: 1.25 mm thickness-image-reconstruction) and 18F-Fluoride-PET/MDCT (MDCT: 1.25 mm thickness-image-reconstruction) in identifying bone metastases in breast cancer patients. Methods: We studied 39 breast cancer patients for bone metastases. Imaging was performed on an integrated PET/MDCT-system; CT images were reconstructed at 3.75 mm and 1.25 mm thickness. Two nuclear medicine physicians and one radiologist interpreted blindly 18F-Fluoride-PET/ CT, 18F-Fluoride-PET/MDCT and MDCT. MDCT at 12 months served as the standard of reference. Results: Overall, 662 bone lesions were detected in our analysis. Of these, 542 were malignant and 120 were benign according to the standard of reference. 18F-Fluoride-PET/CT detected 491 bone metastases, 114 (23%) of which displayed no clear morphological changes on MDCT, whereas MDCT detected 416 bone metastases, 39 (9.3%) of which showed no 18F-Fluoride-PET uptake. Overall sensitivity and specificity were: 91% and 91%, respectively, for 18F-Fluoride-PET/CT, and 77% and 93% for MDCT. The integrated assessment of 18F-Fluoride-PET/MDCT yielded sensitivity and specificity values of 98% and 93%, respectively. Conclusions: 18F-Fluoride-PET/MDCT has higher diagnostic accuracy than 18F-Fluoride-PET/CT and MDCT for the evaluation of bone metastases in breast cancer.

Original languageEnglish
Pages (from-to)2632-2638
Number of pages7
JournalEuropean Journal of Radiology
Volume81
Issue number10
DOIs
Publication statusPublished - Oct 2012

Keywords

  • F-Fluoride
  • Bone metastases
  • Breast cancer
  • PET/CT
  • PET/MDCT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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