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Zhang L, Chen F, Xu L, Li N, Zhuo Q, Guo Y, Wang X, Wen M, Zhao Z, Li M. Comprehensive review of solid tumor bone marrow metastasis. Crit Rev Oncol Hematol 2024; 194:104248. [PMID: 38145832 DOI: 10.1016/j.critrevonc.2023.104248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 12/03/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
Bone marrow metastasis (BMM) of solid tumors refers to a group of diseases that originate from non-hematopoietic malignant tumor cells invading the bone marrow (BM) through complex metastatic patterns. If BMM identification is delayed, the disease will rapidly develop into disseminated carcinogenesis of the BM, which manifests as a series of hematological disorders and microangiopathic hemolytic anemia, leading to serious life-threatening conditions. Although the study of solid tumor BMM is receiving increasing attention, study remains limited, and most descriptions are derived from case reports. Currently, clinicians have insufficient understanding of BMM, and BMM occurrence is often not recognized early or treated effectively, resulting in high mortality rates. In this article, we review the epidemiology, molecular mechanisms, clinical diagnosis, treatment, and prognosis of solid tumor BMM.
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Affiliation(s)
- Lanxin Zhang
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Fengxi Chen
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lingzhi Xu
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ning Li
- Dalian Medical University, Dalian, Liaoning, China
| | - Qiping Zhuo
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yijin Guo
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xueqing Wang
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Meijie Wen
- Department of Anesthesia & Operating Theater, China-Japan Friendship Hospital, Beijing, China
| | - Zuowei Zhao
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China; Department of Breast Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Man Li
- Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China.
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2
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Alavi A, Saboury B, Nardo L, Zhang V, Wang M, Li H, Raynor WY, Werner TJ, Høilund-Carlsen PF, Revheim ME. Potential and Most Relevant Applications of Total Body PET/CT Imaging. Clin Nucl Med 2022; 47:43-55. [PMID: 34874348 DOI: 10.1097/rlu.0000000000003962] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT The introduction of total body (TB) PET/CT instruments over the past 2 years has initiated a new and exciting era in medical imaging. These instruments have substantially higher sensitivity (up to 68 times) than conventional modalities and therefore allow imaging the entire body over a short period. However, we need to further refine the imaging protocols of this instrument for different indications. Total body PET will allow accurate assessment of the extent of disease, particularly, including the entire axial and appendicular skeleton. Furthermore, delayed imaging with this instrument may enhance the sensitivity of PET for some types of cancer. Also, this modality may improve the detection of venous thrombosis, a common complication of cancer and chemotherapy, in the extremities and help prevent pulmonary embolism. Total body PET allows assessment of atherosclerotic plaques throughout the body as a systematic disease. Similarly, patients with widespread musculoskeletal disorders including both oncologic and nononcologic entities, such as degenerative joint disease, rheumatoid arthritis, and osteoporosis, may benefit from the use of TB-PET. Finally, quantitative global disease assessment provided by this approach will be superior to conventional measurements, which do not reflect overall disease activity. In conclusion, TB-PET imaging may have a revolutionary impact on day-to-day practice of medicine and may become the leading imaging modality in the future.
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Affiliation(s)
- Abass Alavi
- From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | - Lorenzo Nardo
- Department of Radiology, University of California, Davis, Sacramento, CA
| | - Vincent Zhang
- From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital, Henan, China
| | - Hongdi Li
- United Imaging Healthcare, Houston, TX
| | - William Y Raynor
- From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Thomas J Werner
- From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
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Ingley KM, Wan S, Vöö S, Windsor R, Michelagnoli M, Saifuddin A, Strauss SJ. Is It Time to Call Time on Bone Marrow Biopsy for Staging Ewing Sarcoma (ES)? Cancers (Basel) 2021; 13:cancers13133261. [PMID: 34209887 PMCID: PMC8267963 DOI: 10.3390/cancers13133261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Ewing sarcoma (ES) is a rare primary bone cancer, usually found in children and adolescents, which can spread to the lungs, other bones and less commonly, the bone marrow. An accurate determination of the disease spread at baseline (staging) is important to establish prognosis, monitor treatment response and help with management decisions. There is no standard of care for staging ES, although the invasive bone marrow biopsy has traditionally been used to establish whether patients have bone marrow infiltration. Imaging techniques, including FDG-PET/CT and whole-body MRI (WB-MRI), have become established in staging other cancers with expanding use for staging ES. A number of studies have validated the accuracy, sensitivity and specificity of these modalities for detecting bone and bone marrow metastases in ES. The main aim of this review was to examine the current literature for the use of FDG-PET/CT and WB-MRI in staging ES to determine whether a bone marrow biopsy is still needed and would influence the management of patients. Hereafter, a new staging algorithm for ES recommends WB-MRI and/or FDG-PET/CT without bone marrow biopsy as the standard of care for staging localised and metastatic ES. Abstract Primary malignant bone sarcomas are rare and Ewing sarcoma (ES), along with osteosarcoma, predominates in teenagers and young adults. The well-established multimodality treatment incorporates systemic chemotherapy with local control in the form of surgery, with or without radiation. The presence and extent of metastases at diagnosis remains the most important prognostic factor in determining patient outcome; patients with skeletal metastases or bone marrow infiltration having a significantly worse outcome than those with lung metastases alone. There is, however, no accepted staging algorithm for ES. Large cooperative groups and national guidelines continue to advocate bone marrow biopsy (BMB) for staging but functional imaging techniques, such as 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with computerised tomography (CT) have been increasingly used for staging cancers and whole-body magnetic resonance imaging (WB-MRI) for staging skeletal metastases. This review outlines the current literature, from which we conclude that BMB is no longer required for the staging of ES as it does not influence the standard of care management. BMB may, however, provide prognostic information and insights into the biology of ES in selected patients on prospective clinical trials.
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Affiliation(s)
- Katrina M. Ingley
- The London Sarcoma Service, University College London Hospitals Foundation Trusts, London NW1 2BU, UK; (K.M.I.); (R.W.); (M.M.)
| | - Simon Wan
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, London NW1 2BU, UK; (S.W.); (S.V.)
| | - Stefan Vöö
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, London NW1 2BU, UK; (S.W.); (S.V.)
- Biomedical Research Centre, Inflammation, Immunity and Immunotherapeutics, University College London Hospital, London NW1 2BU, UK
| | - Rachael Windsor
- The London Sarcoma Service, University College London Hospitals Foundation Trusts, London NW1 2BU, UK; (K.M.I.); (R.W.); (M.M.)
| | - Maria Michelagnoli
- The London Sarcoma Service, University College London Hospitals Foundation Trusts, London NW1 2BU, UK; (K.M.I.); (R.W.); (M.M.)
| | - Asif Saifuddin
- Department of Radiology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, London HA7 4LP, UK;
| | - Sandra J. Strauss
- The London Sarcoma Service, University College London Hospitals Foundation Trusts, London NW1 2BU, UK; (K.M.I.); (R.W.); (M.M.)
- UCL Cancer Institute, University College, London WC1E 6DD, UK
- Correspondence:
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Khaw TH, Raynor WY, Borja AJ, Al-Zaghal A, Jonnakuti VS, Cheng N, Houshmand S, Werner TJ, Alavi A. Assessing the effects of body weight on subchondral bone formation with quantitative 18F-sodium fluoride PET. Ann Nucl Med 2020; 34:559-564. [PMID: 32524505 DOI: 10.1007/s12149-020-01482-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/30/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to quantify subchondral bone remodeling in the elbows, hands, knees, and feet using volumetric and metabolic parameters derived from 18F-sodium fluoride positron emission tomography (NaF-PET) and to assess the convergent validity of these parameters as an index of joint degeneration and preclinical osteoarthritis. METHODS A retrospective analysis was conducted in 34 subjects (32 males, 2 females) with metastatic bone disease who underwent full-body NaF-PET/CT scans. An adaptive contrast-oriented thresholding algorithm was applied to segment NaF-avid regions in the bilateral elbows, hands, knees, and feet of each subject, and metabolically active volume (MAV), maximum standardized uptake value (SUVmax), mean metabolic volumetric product (MVPmean), and partial volume-corrected MVPmean (cMVPmean) of the segmented regions were calculated. Global parameters for MAV, SUVmax, MVPmean, and cMVPmean were defined as the sum of the corresponding values in all the joints of a subject. Inter-rater reliability was determined with Lin's concordance correlation, and associations of global values with subject body weight and age were assessed with Pearson correlation and Spearman correlation analyses. RESULTS Inter-rater reliability was observed to be the highest in SUVmax (ρc = 0.99), followed by MVPmean (ρc = 0.96), cMVPmean (ρc = 0.93), and MAV (ρc = 0.93). MAV, MVPmean, and cMVPmean were observed to significantly increase with weight (all p < 0.0001) determined by Pearson correlation. In addition, Spearman rank-order analysis demonstrated a significant correlation between SUVmax and weight in addition to MAV, MVPmean, and cMVPmean and weight (all p < 0.01). No significant association between age and any PET parameter was observed. CONCLUSIONS These preliminary data demonstrate the feasibility and reliability of assessing bone turnover at the joints using quantitative NaF-PET. Our findings corroborate the fact that biomechanical factors including mechanical loading and weight-bearing are contributors to osteoarthritis disease progression.
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Affiliation(s)
- Tiffany H Khaw
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Austin J Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Abdullah Al-Zaghal
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
| | - Venkata S Jonnakuti
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
| | - Nina Cheng
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
| | - Sina Houshmand
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
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Loudini N, Glaudemans AWJM, Jutte PC, Yakar D, Kwee TC. The value of prebiopsy FDG-PET/CT in discriminating malignant from benign vertebral bone lesions in a predominantly oncologic population. Skeletal Radiol 2020; 49:1387-1395. [PMID: 32253470 PMCID: PMC7360653 DOI: 10.1007/s00256-020-03426-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/18/2020] [Accepted: 03/23/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the value of prebiopsy 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)/computed tomography (CT) in discriminating malignant from benign vertebral bone lesions. MATERIALS AND METHODS This retrospective study included 53 patients with 55 vertebral bone lesions that underwent FDG-PET/CT before CT-guided biopsy. Pathologic examination of the biopsy sample and a minimum follow-up of 1 year were used as reference standard. RESULTS Sensitivity, specificity, positive predictive value, and negative predictive value of visual FDG-PET analysis (with lesion FDG uptake higher than liver FDG uptake as threshold for malignancy) in discriminating malignant from benign vertebral bone lesions were 91.3% (42/46), 22.2% (2/9), 85.7% (42/49), and 33.3% (2/6), respectively. The semiquantitative FDG-PET metrics SUVmax and SUVpeak achieved areas under the receiver operating characteristics curve of 0.630 and 0.671, respectively. Malignant lesions demonstrated bone lysis more frequently than benign lesions (60.9% (28/46) vs. 22.2% (2/9)), and this difference was nearly significant (P = 0.064). All other clinical and conventional imaging characteristics (including patient age, gender, previous diagnosis of malignancy, bone pain, weight loss, any CT abnormality, sclerosis, cortical destruction, bone marrow replacement, associated extraosseous soft tissue mass, and accompanying vertebral height loss, multiple bone lesions on FDG-PET/CT, and suspicious extraosseous lesions on FDG-PET/CT) were not significantly different (P = 0.143 to 1.000). CONCLUSION FDG-PET/CT may steer the diagnosis (particularly thanks to a relatively high PPV and value of semiquantitative measurements), but cannot always classify vertebral bone lesions as malignant or benign with sufficient certainty. In these cases, biopsy and/or follow-up remain necessary to establish a final diagnosis.
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Affiliation(s)
- Naila Loudini
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, |Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Andor W. J. M. Glaudemans
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, |Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Paul C. Jutte
- Department of Orthopedics, |University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Derya Yakar
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, |Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Thomas C. Kwee
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, |Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
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Høilund-Carlsen PF, Alavi A. 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 2019; 22:219-220. [PMID: 31808031 DOI: 10.1007/s11307-019-01449-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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7
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Høilund-Carlsen PF, Alavi A. Off-Target Report on 18F-Sodium Fluoride PET/CT for Detection of Skeletal Metastases in Prostate Cancer. J Nucl Med 2019; 60:1835-1836. [DOI: 10.2967/jnumed.119.232348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Raynor WY, Al-Zaghal A, Zadeh MZ, Seraj SM, Alavi A. Metastatic Seeding Attacks Bone Marrow, Not Bone: Rectifying Ongoing Misconceptions. PET Clin 2019; 14:135-144. [PMID: 30420215 DOI: 10.1016/j.cpet.2018.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Conventional modalities, such as bone scintigraphy, are commonly used to assess osseous abnormalities in skeletal metastasis. Fluorine-18 (18F)-sodium fluoride (NaF) PET similarly portrays osteoblastic activity but with improved spatial and contrast resolution and more accurate anatomic localization. However, these modalities rely on indirect evidence for tumor activity. PET imaging with 18F-fluorodeoxyglucose (FDG) and tumor-specific tracers may have an increased role by directly portraying the metabolic activity of cancer cells, which are often seeded in bone marrow and cause osseous disease after initial latency. This article describes the utility and limitations of these modalities in assessing skeletal metastases.
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Affiliation(s)
- William Y Raynor
- Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Department of Radiology, Drexel University College of Medicine, 230 N Broad Street, Philadelphia, PA 19102, USA
| | - Abdullah Al-Zaghal
- Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mahdi Zirakchian Zadeh
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Siavash Mehdizadeh Seraj
- Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Høilund-Carlsen PF, Hess S, Werner TJ, Alavi A. Cancer metastasizes to the bone marrow and not to the bone: time for a paradigm shift! Eur J Nucl Med Mol Imaging 2018; 45:893-897. [PMID: 29468310 PMCID: PMC5915506 DOI: 10.1007/s00259-018-3959-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Poul Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Søren Hess
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Radiology and Nuclear Medicine, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
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10
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Georgi TW, Kluge R, Kurch L, Chavdarova L, Hasenclever D, Stoevesandt D, Pelz T, Landman-Parker J, Wallace WH, Karlen J, Fernández-Teijeiro A, Cepelova M, Fosså A, Balwierz W, Attarbaschi A, Ammann RA, Pears J, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Daw S, Baumann J, Körholz D, Sabri O, Mauz-Körholz C. 18F-FDG PET Response of Skeletal (Bone Marrow and Bone) Involvement After Induction Chemotherapy in Pediatric Hodgkin Lymphoma: Are Specific Response Criteria Required? J Nucl Med 2018; 59:1524-1530. [PMID: 29653979 DOI: 10.2967/jnumed.117.205633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/23/2018] [Indexed: 11/16/2022] Open
Abstract
To determine whether the current 18F-FDG PET response criterion for skeletal involvement in Hodgkin lymphoma (HL) is suitable, we performed a systematic evaluation of the different types of skeletal involvement and their response on PET after 2 cycles of chemotherapy (PET-2). A secondary objective was to observe the influence of the initial uptake intensity (measured as qPET) and initial metabolic tumor volume (MTV) of skeletal lesions on the PET-2 response. Methods: The initial PET scans of 1,068 pediatric HL patients from the EuroNet-PHL-C1 trial were evaluated for skeletal involvement by central review. Three types of skeletal lesions were distinguished: PET-only lesions (those detected on PET only), bone marrow (BM) lesions (as confirmed by MRI or BM biopsy), and bone lesions. qPET and MTV were calculated for each skeletal lesion. All PET-2 scans were assessed for residual tumor activity. The rates of complete metabolic response for skeletal and nodal involvement on PET-2 were compared. Results: Of the 1,068 patients, 139 (13%) showed skeletal involvement (44 PET-only, 32 BM, and 63 bone). Of the 139 patients with skeletal involvement, 101 (73%) became PET-2-negative in the skeleton and 94 (68%) became PET-2-negative in the lymph nodes. The highest number of PET-2-negative scans in the skeleton was 42 (95%) in the 44 PET-only patients, followed by 22 skeletal lesions (69%) in the 32 BM patients and 37 (59%) in the 63 bone patients. Lesions that became PET-2-negative showed a lower initial median qPET (2.74) and MTV (2 cm3) than lesions that remained PET-2-positive (3.84 and 7 cm3, respectively). Conclusion: In this study with pediatric HL patients, the complete response rate for skeletal involvement on PET-2 was similar to that for nodal involvement. Bone flare seemed to be irrelevant. Overall, the current skeletal PET response criterion-comparison with the local skeletal background-is well suited. The initial qPET and MTV of skeletal lesions were predictive of the PET-2 result. Higher values for both parameters were associated with a worse PET-2 response.
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Affiliation(s)
- Thomas W Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lidia Chavdarova
- Department of Nuclear Medicine, National Hospital for Active Treatment in Oncology, Sofia, Bulgaria
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | | | - Tanja Pelz
- Department of Radiotherapy, University of Halle, Halle (Saale), Germany
| | | | - W Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, United Kingdom
| | - Jonas Karlen
- Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden
| | - Ana Fernández-Teijeiro
- Pediatric Oncology Unit, Hospitales Universitarios Virgen Macarena y Virgen del Rocio, Sevilla, Spain
| | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Roland A Ammann
- Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jane Pears
- Our Lady's Children's Hospital, Dublin, Ireland
| | | | | | - Auke Beishuizen
- Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Karin Dieckmann
- Universitätsklinik für Strahlentherapie und Strahlenbiologie, Medizinische Universität Wien, Wien, Austria
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Stephen Daw
- University College London Hospitals, London, United Kingdom; and
| | - Julia Baumann
- Department of Pediatric Oncology, Justus-Liebig-University, Giessen, Germany
| | - Dieter Körholz
- Department of Pediatric Oncology, Justus-Liebig-University, Giessen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Høilund-Carlsen PF, Hess S, Alavi A. Bone Marrow and NOT Bone Metastases Is What 21st-Century Diagnostic Imaging Must Focus on When Looking for Skeletal Metastases. J Nucl Med 2017; 59:1165. [DOI: 10.2967/jnumed.117.201848] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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12
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Raynor W, Houshmand S, Gholami S, Emamzadehfard S, Rajapakse CS, Blomberg BA, Werner TJ, Høilund-Carlsen PF, Baker JF, Alavi A. Evolving Role of Molecular Imaging with (18)F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism. Curr Osteoporos Rep 2016; 14:115-25. [PMID: 27301549 DOI: 10.1007/s11914-016-0312-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
(18)F-sodium fluoride (NaF) as an imaging tracer portrays calcium metabolic activity either in the osseous structures or in soft tissue. Currently, clinical use of NaF-PET is confined to detecting metastasis to the bone, but this approach reveals indirect evidence for disease activity and will have limited use in the future in favor of more direct approaches that visualize cancer cells in the read marrow where they reside. This has proven to be the case with FDG-PET imaging in most cancers. However, a variety of studies support the application of NaF-PET to assess benign osseous diseases. In particular, bone turnover can be measured from NaF uptake to diagnose osteoporosis. Several studies have evaluated the efficacy of bisphosphonates and their lasting effects as treatment for osteoporosis using bone turnover measured by NaF-PET. Additionally, NaF uptake in vessels tracks calcification in the plaques at the molecular level, which is relevant to coronary artery disease. Also, NaF-PET imaging of diseased joints is able to project disease progression in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Further studies suggest potential use of NaF-PET in domains such as back pain, osteosarcoma, stress-related fracture, and bisphosphonate-induced osteonecrosis of the jaw. The critical role of NaF-PET in disease detection and characterization of many musculoskeletal disorders has been clearly demonstrated in the literature, and these methods will become more widespread in the future. The data from PET imaging are quantitative in nature, and as such, it adds a major dimension to assessing disease activity.
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Affiliation(s)
- William Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Sina Houshmand
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Saeid Gholami
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Sahra Emamzadehfard
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Chamith S Rajapakse
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Björn Alexander Blomberg
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | | | - Joshua F Baker
- Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
- Division of Rheumatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
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Capitanio S, Bongioanni F, Piccardo A, Campus C, Gonella R, Tixi L, Naseri M, Pennone M, Altrinetti V, Buschiazzo A, Bossert I, Fiz F, Bruno A, DeCensi A, Sambuceti G, Morbelli S. Comparisons between glucose analogue 2-deoxy-2-( 18F)fluoro-D-glucose and 18F-sodium fluoride positron emission tomography/computed tomography in breast cancer patients with bone lesions. World J Radiol 2016; 8:200-209. [PMID: 26981229 PMCID: PMC4770182 DOI: 10.4329/wjr.v8.i2.200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/08/2015] [Accepted: 12/11/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare 2-deoxy-2-(18F)fluoro-D-glucose(18F-FDG) and 18F-sodium (18F-NaF) positron emission tomography/computed tomography (PET/CT) accuracy in breast cancer patients with clinically/radiologically suspected or known bone metastases.
METHODS: A total of 45 consecutive patients with breast cancer and the presence or clinical/biochemical or radiological suspicion of bone metastatic disease underwent 18F-FDG and 18F-fluoride PET/CT. Imaging results were compared with histopathology when available, or clinical and radiological follow-up of at least 1 year. For each technique we calculated: Sensitivity (Se), specificity (Sp), overall accuracy, positive and negative predictive values, error rate, and Youden’s index. McNemar’s χ2 test was used to test the difference in sensitivity and specificity between the two diagnostic methods. All analyses were computed on a patient basis, and then on a lesion basis, with consideration ofthe density of independent lesions on the co-registered CT (sclerotic, lytic, mixed, no-lesions) and the divergent site of disease (skull, spine, ribs, extremities, pelvis). The impact of adding 18F-NaF PET/CT to the work-up of patients was also measured in terms of change in their management due to 18F-NaF PET/CT findings.
RESULTS: The two imaging methods of 18F-FDG and 18F-fluoride PET/CT were significantly different at the patient-based analysis: Accuracy was 86.7% and 84.4%, respectively (McNemar’s χ2 = 6.23, df = 1, P = 0.01). Overall, 244 bone lesions were detected in our analysis. The overall accuracy of the two methods was significantly different at lesion-based analysis (McNemar’s χ2 = 93.4, df = 1, P < 0.0001). In the lesion density-based and site-based analysis, 18F-FDG PET/CT provided more accurate results in the detection of CT-negative metastasis (P < 0.002) and vertebral localizations (P < 0.002); 18F-NaF PET/CT was more accurate in detecting sclerotic (P < 0.005) and rib lesions (P < 0.04). 18F-NaF PET/CT led to a change of management in 3 of the 45 patients (6.6%) by revealing findings that were not detected at 18F-FDG PET/CT.
CONCLUSION: 18F-FDG PET/CT is a reliable imaging tool in the detection of bone metastasis in most cases, with a diagnostic accuracy that is slightly, but significantly, superior to that of 18F-NaF PET/CT in the general population of breast cancer patients. However, the extremely high sensitivity of 18F-fluoride PET/CT can exploit its diagnostic potential in specific clinical settings (i.e., small CT-evident sclerotic lesions, high clinical suspicious of relapse, and negative 18F-FDG PET and conventional imaging).
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Gunalp B, Oner AO, Ince S, Alagoz E, Ayan A, Arslan N. Evaluation of radiographic and metabolic changes in bone metastases in response to systemic therapy with (18)FDG-PET/CT. Radiol Oncol 2015; 49:115-20. [PMID: 26029021 PMCID: PMC4387986 DOI: 10.1515/raon-2015-0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 02/09/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to retrospectively evaluate radiographic and metabolic changes in bone metastases in response to systemic therapy with (18)FDG-PET/CT and determine their roles on the evaluation of therapy response. PATIENTS AND METHODS We retrospectively evaluated radiographic and metabolic characteristics of bone metastases in 30 patients who were referred for the evaluation of response to systemic therapy with (18)FDG-PET/CT. All patients underwent integrated (18)FDG-PET/CT before and after treatment. RESULTS The baseline radiographic patterns of the target lesions in responders group were lytic, sclerotic, mixed and CT negative; after treatment the radiographic patterns of all target lesions changed to a sclerotic pattern and attenuation increased (p = 0.012) and metabolic activity decreased (p = 0.012). A correlation was found between decreasing metabolic activity and increasing attenuation of the target lesions (r = -0.55) (p = 0.026). However, in nonresponders group, the baseline radiologic patterns of the target lesions were lytic, blastic, mixed and CT negative; after treatment all lytic target lesions remained the same and one CT negative lesion turned to lytic pattern and the attenuation of the target lesions decreased (p ± 0.12) and metabolic activity increased (p = 0.012). A correlation was found between increasing metabolic activity and decreasing attenuation (r = -0.65) (p = 0.032). An exception of this rule was seen in baseline blastic metastases which progressed with increasing in size, metabolic activity and attenuation. CONCLUSIONS This study shows that the metabolic activity of lesions is a more reliable parameter than the radiographic patterns for the evaluation of therapy response.
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Affiliation(s)
- Bengul Gunalp
- Gulhane Military Medical Academy and Faculty, Department of Nuclear Medicine, Ankara, Turkey
| | - Ali Ozan Oner
- Kocatepe University Medical Faculty, Department of Nuclear Medicine, Afyon, Turkey
| | - Semra Ince
- Gulhane Military Medical Academy and Faculty, Department of Nuclear Medicine, Ankara, Turkey
| | - Engin Alagoz
- Gulhane Military Medical Academy and Faculty, Department of Nuclear Medicine, Ankara, Turkey
| | - Aslı Ayan
- Gulhane Military Medical Academy and Faculty, Department of Nuclear Medicine, Ankara, Turkey
| | - Nuri Arslan
- Gulhane Military Medical Academy and Faculty, Department of Nuclear Medicine, Ankara, Turkey
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Affiliation(s)
- Hugo J A Adams
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Thomas C Kwee
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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Bone marrow FDG-PET/CT in Hodgkin lymphoma revisited: do imaging and pathology match? Ann Nucl Med 2014; 29:132-7. [PMID: 25348549 DOI: 10.1007/s12149-014-0920-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 10/09/2014] [Indexed: 01/19/2023]
Abstract
PURPOSE To directly compare visual and quantitative (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) to bone marrow biopsy (BMB) findings in the right posterior iliac crest in patients with newly diagnosed Hodgkin lymphoma. MATERIALS AND METHODS This retrospective study included 26 patients with newly diagnosed Hodgkin lymphoma in whom FDG-PET/CT was performed before BMB of the right posterior iliac crest. The right posterior iliac crest was assessed for bone marrow involvement, both visually and semi-quantitatively [using maximum standardized uptake value (SUVmax) measurements]. BMB of right the posterior iliac crest was used as reference standard. RESULTS BMB of the right posterior iliac crest was positive in 5 (19.2 %) of 26 patients. There was full agreement between visual FDG-PET/CT and BMB findings in the right posterior iliac crest (i.e. no false-positive or false-negative FDG-PET/CT findings). Accordingly, sensitivity, specificity, positive predictive value, and negative predictive value of visual FDG-PET/CT assessment for the detection of bone marrow involvement in the right posterior iliac crest were 100 % (5/5) (95 % CI 51.1-100 %), 100 % (21/21) (95 % CI 81.8-100 %), 100 % (5/5) (95 % CI 51.1-100 %), and 100 % (21/21) (95 % CI 81.8-100 %), respectively. SUVmax of BMB-positive cases (mean ± SD: 3.4 ± 0.85) was nearly significantly higher (P = 0.052) than that of BMB-negative cases (mean ± SD 2.7 ± 0.63). CONCLUSION This histopathological correlation study confirms the very high diagnostic value of FDG-PET/CT in the detection of bone marrow involvement in newly diagnosed Hodgkin lymphoma, and supports the substitution of BMB with FDG-PET/CT in this setting.
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Vermoolen MA, Kersten MJ, Fijnheer R, van Leeuwen MS, Kwee TC, Nievelstein RAJ. Magnetic resonance imaging of malignant lymphoma. Expert Rev Hematol 2014; 4:161-71. [DOI: 10.1586/ehm.11.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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18
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Critical considerations on the combined use of 18F-FDG and 18F-fluoride for PET assessment of metastatic bone disease. Eur J Nucl Med Mol Imaging 2013; 40:1141-5. [DOI: 10.1007/s00259-013-2459-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/06/2013] [Indexed: 01/18/2023]
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Adams HJA, Kwee TC, Vermoolen MA, de Keizer B, de Klerk JMH, Adam JA, Fijnheer R, Kersten MJ, Stoker J, Nievelstein RAJ. Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET. Eur Radiol 2013; 23:2271-8. [PMID: 23591618 DOI: 10.1007/s00330-013-2835-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 02/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess and compare the value of whole-body MRI with FDG-PET for detecting bone marrow involvement in lymphoma. METHODS A total of 116 patients with newly diagnosed lymphoma prospectively underwent whole-body MRI and blind bone marrow biopsy (BMB) of the posterior iliac crest. Of 116 patients, 80 also underwent FDG-PET. Patient-based sensitivities of whole-body MRI for detecting bone marrow involvement were calculated using BMB as reference standard and compared with FDG-PET in aggressive and indolent lymphomas separately. RESULTS Sensitivity of whole-body MRI in all lymphomas was 45.5 % [95 % confidence interval (CI): 29.8-62.0 %]. Sensitivity of whole-body MRI in aggressive lymphoma [88.9 % (95 % CI: 54.3-100 %)] was significantly higher (P = 0.0029) than that in indolent lymphoma [23.5 % (95 % CI: 9.1-47.8 %)]. Sensitivity of FDG-PET in aggressive lymphoma [83.3 % (95 % CI: 41.8-98.9 %)] was also significantly higher (P = 0.026) than that in indolent lymphoma [12.5 % (95 % CI: 0-49.2 %)]. There were no significant differences in sensitivity between whole-body MRI and FDG-PET (P = 1.00) CONCLUSION: Sensitivity of whole-body MRI for detecting lymphomatous bone marrow involvement is too low to (partially) replace BMB. Sensitivity of whole-body MRI is significantly higher in aggressive lymphoma than in indolent lymphoma and is equal to FDG-PET in both entities. KEY POINTS • Bone marrow involvement in lymphoma has prognostic and therapeutic implications. • Blind bone marrow biopsy (BMB) is standard for bone marrow assessment. • Neither whole-body MRI nor FDG-PET can yet replace BMB. • Both techniques have higher sensitivity in aggressive than in indolent lymphoma. • Both imaging techniques are complementary to BMB.
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Affiliation(s)
- Hugo J A Adams
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Selcukbiricik F, Yildiz O, Yilmaz S, Tural D, Turna H, Mandel NM, Tuzuner N, Serdengecti S, Halac M. Increasing Role of FDG-PET/CT in Detecting Bone Marrow Metastasis of Solid Tumors in Adults: An Analysis of Ten Patients. World J Oncol 2013; 3:271-279. [PMID: 29147318 PMCID: PMC5649805 DOI: 10.4021/wjon598w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2012] [Indexed: 12/22/2022] Open
Abstract
Background We aimed to test the hypothesis that whether FDG-PET/CT which was ordered for various purposes can predict suspected or particularly unsuspected bone marrow metastasis (BMM) from the complete blood count and therefore can change the management of these patients. Methods In this retrospective study, the study sample consisted of 68 subsequent patients presented to our institution’s pathology department with bone marrow metastases of solid tumors. PET/CT was found to have been ordered in 10 out of 68 patients (6.8%) for various purposes. All patients gave informed consent about the PET/CT examinations and bone marrow biopsies. Result FDG-PET/CT was ordered in 10 out of 68 solid tumor patients with pathologically proven BMM. Of these 10 patients, 3 were female and 7 were male; mean age was 54.7 years. While FDG PET/CT showed bone and BMM in 4 of 10 patients (40%), the rest of the patients had BMM without bone involvement. Five patients (50%) who had probable bone marrow involvement on their FDG PET/CT scans had unsuspected complete blood counts with regard to BMM. Conclusion PET/CT has the ability to detect a substantial number of metabolically active tumor cells in the bone marrow in all of our patients which we proved by bone marrow biopsies. We think that this cohort of patients with solid tumors is hypothesis-generating with regard to detecting early bone marrow metastases by FDG PET/CT.
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Affiliation(s)
- Fatih Selcukbiricik
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Ozcan Yildiz
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Sabire Yilmaz
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Nuclear Medicine, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Deniz Tural
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Hande Turna
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Nil Molinas Mandel
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Nukhet Tuzuner
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Pathology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Suheyla Serdengecti
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Medical Oncology, Istanbul University, Kocamustafapasa, Istanbul, Turkey
| | - Metin Halac
- Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Istanbul, Turkey.,Department of Nuclear Medicine, Istanbul University, Kocamustafapasa, Istanbul, Turkey
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Kwee TC, Nievelstein RAJ. Is MRI less accurate than FDG-PET/CT in diagnosing bone marrow involvement in lymphoma? Eur J Radiol 2011; 80:565-6. [PMID: 21237596 DOI: 10.1016/j.ejrad.2010.12.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Accepted: 12/20/2010] [Indexed: 11/24/2022]
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Portilla-Quattrociocchi H, Banzo I, Martínez-Rodríguez I, Quirce R, Jiménez-Bonilla J, Torres MDA, Medina-Quiroz P, del Castillo R, Rubio-Vassallo A, Carril J. Evaluación de la gammagrafía ósea y la 18F-FDG PET/TAC en las metástasis óseas del cáncer de pulmón. ACTA ACUST UNITED AC 2011; 30:2-7. [DOI: 10.1016/j.remn.2010.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/19/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
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Liu N, Ma L, Zhou W, Pang Q, Hu M, Shi F, Fu Z, Li M, Yang G, Yu J. Bone metastasis in patients with non-small cell lung cancer: The diagnostic role of F-18 FDG PET/CT. Eur J Radiol 2010; 74:231-5. [DOI: 10.1016/j.ejrad.2009.01.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 01/28/2009] [Accepted: 01/30/2009] [Indexed: 01/22/2023]
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Basu S, Rao R. Combined 18F-FDG and Fluoride Approach in PET/CT Imaging: Is There a Clinical Future? J Nucl Med 2009; 51:165; author reply 166-7. [DOI: 10.2967/jnumed.109.066860] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Beheshti M, Langsteger W. PET/CT for Monitoring Therapy Response in Breast Cancer Patients with Bone Metastases. Radiology 2008; 249:389-90; author reply 390. [DOI: 10.1148/radiol.2491080816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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