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Jiang M, Yu Q, Mei H, Jian Y, Xu R. Early diagnostic value of ECT whole-body bone imaging combined with PINP and β-CTX for bone metastasis of lung cancer. Clin Transl Oncol 2024:10.1007/s12094-024-03475-8. [PMID: 38814542 DOI: 10.1007/s12094-024-03475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/21/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE This research was aimed at investigating the early diagnostic value of emission computed tomograph (ECT) whole-body bone imaging combined with PINP and β-CTX for bone metastasis of lung cancer. METHODS Case data of 86 lung cancer patients were categorized into lung cancer with bone metastasis (LCWBM, 46 cases) and lung cancer without bone metastasis (LCWOBM, 40 cases) groups according to the presence or absence of bone metastasis. Patients' general information were collected. ECT whole-body bone imaging was used to detect bone metastases and the grading of the extent of disease (EOD) in both groups, and electrochemiluminescence was utilized to detect the serum levels of PINP and β-CTX. Spearman correlation analysis was employed to evaluate the correlation between EOD grading and PINP and β-CTX levels. Logistic univariate and multivariate regression was implemented to analyze the risk factors of bone metastasis of lung cancer. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of the single test of ECT whole-body bone imaging, PINP, or β-CTX and the combination of the three tests. RESULTS The differences in pathological type, clinical stage and EOD grading, the number of positive ECT cases, and the expression levels of PINP and β-CTX between the LCWBM and LCWOBM groups were statistically significant. In LCWBM patients with different EOD grading, the trends of the expression of PINP and β-CTX were grade 3 > grade 2 > grade 1 and grade 0. Further correlation analyses revealed that EOD grading showed a significant positive correlation with the PINP and β-CTX expression levels. Univariate logistic regression analysis demonstrated that adenocarcinoma, TNM stage IV, ECT positivity, and high expression of PINP and β-CTX were associated with bone metastasis of lung cancer, and multivariate logistic regression analysis indicated that ECT positivity, high expression of PINP and β-CTX were independent risk factors for bone metastasis of lung cancer. The area under the curve (AUC) of ECT, PINP, and β-CTX alone for the diagnosis of bone metastasis of lung cancer were 0.872, 0.888, and 0.874, respectively, and the AUC for the combined diagnosis of the three was 0.963, which was greater than that of any one of the individual indices, with a sensitivity of 86.96% and a specificity of 97.50% at a Youden index of 0.845. CONCLUSION ECT whole-body bone imaging combined with PINP and β-CTX has high diagnostic value for bone metastasis of lung cancer.
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Affiliation(s)
- Meiying Jiang
- Department of Nuclear MedicineDonghu DistrictJiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No.92 Aiguo Road, Nanchang, 330006, China
| | - Qiyun Yu
- Department of Nuclear MedicineDonghu DistrictJiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No.92 Aiguo Road, Nanchang, 330006, China
| | - Haitao Mei
- Department of Nuclear MedicineDonghu DistrictJiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No.92 Aiguo Road, Nanchang, 330006, China
| | - Yingchao Jian
- Department of Radiology, Donghu District, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No. 92 Aiguo Road, Jiangxi Province, 330006, China.
| | - Rong Xu
- Department of Nuclear MedicineDonghu DistrictJiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, No.92 Aiguo Road, Nanchang, 330006, China.
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Wang D, Guo C, Xiao J. The potential advantages of 18F sodium fluoride positron emission tomography-computed tomography for clinical staging and management planning in patients with nasopharyngeal carcinoma. Quant Imaging Med Surg 2024; 14:3393-3404. [PMID: 38720843 PMCID: PMC11074759 DOI: 10.21037/qims-23-1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/06/2024] [Indexed: 05/12/2024]
Abstract
Background The staging and treatment planning of nasopharyngeal carcinoma (NPC) face challenges due to limited sensitivity of conventional imaging. 18F-sodium fluoride (18F-NaF) positron emission tomography-computed tomography (PET/CT) offers potential advantages in detecting early bone involvement. This retrospective cohort study aimed to assess the potential advantage of 18F-NaF PET/CT for clinical staging and management planning in patients with NPC and to compare 18F-NaF PET/CT findings with those of conventional imaging modalities. Methods We enrolled a cohort of patients with NPC who underwent 18F-NaF PET/CT at our PET/CT center between July 1, 2017, and June 30, 2021, and analyzed the findings of 18F-NaF PET/CT and conventional imaging modalities. Data from multidisciplinary team discussions on clinical staging and management planning both before and after 18F-NaF PET/CT were recorded. Additionally, any changes in clinical staging and management planning following 18F-NaF PET/CT were documented. Results A total of 58 patients were included in this study. After 18F-NaF PET/CT imaging, clinical tumor-node-metastasis (TNM) staging was observed to have changed in seven cases (12.1%). Among these, four cases had changes in T stage and three cases in the M stage. Additionally, changes in clinical management plans were observed in eight patients (13.8%). Changes due the results of 18F-NaF PET/CT included three cases with major modification (two cases switched from curative treatment to palliative treatment, and one case switched from palliative treatment to curative treatment) and five cases with minor changes. The minor changes involved alteration to the radiotherapy target volume (three cases with an increased target volume and one case with a reduced target area). Furthermore, one case required an alteration to the radiotherapy strategy for local bone involvement. Conclusions The use of 18F-NaF PET/CT in patients newly diagnosed with NPC may offer potential advantages for clinical staging and treatment planning, enabling physicians to select a more individualized treatment approach.
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Affiliation(s)
- Dong Wang
- Department of Nuclear Medicine (PET-CT Center), Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Chengmao Guo
- Department of Nuclear Medicine (PET-CT Center), Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jingxing Xiao
- Department of Nuclear Medicine (PET-CT Center), Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Fan Z, Wang T, Zou L, Liu D. Comparison of the diagnostic value of 18F-NaF PET/CT and 99mTc-MDP SPECT for bone metastases: a systematic review and meta-analysis. Transl Cancer Res 2023; 12:3166-3178. [PMID: 38130318 PMCID: PMC10731341 DOI: 10.21037/tcr-23-817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/28/2023] [Indexed: 12/23/2023]
Abstract
Background Bone scintigraphy, the standard tool for detecting bone metastases has some insufficiencies; thus, supplementary imaging techniques are needed. This study is a comprehensive meta-analysis of studies reporting and comparing the diagnostic efficacy of 18F-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) and 99mTc-MDP single-photon emission computed tomography (SPECT) for bone metastases. Methods Literature related to the diagnosis of bone metastases using 18F-NaF PET/CT and 99mTc-MDP SPECT was searched on PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang databases, and VIP. Evaluation of study quality was performed according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Pooled sensitivity (SEN) and specificity (SPE) were assessed along with heterogeneity. The subject operating characteristic curve was plotted, the area under the curve (AUC) was calculated, and the pre- and post-test probabilities were compared. Results Finally, 11 articles, consisting of 1,085 patients and 1,782 lesions, were included. At the patient level (11 articles), the results were pooled SEN =0.92 and SPE =0.96 for PET/CT, SEN =0.80 and SPE =0.90 for SPECT. The AUC of PET/CT [0.98 (0.96-0.99)] was higher than that of SPECT [0.92 (0.89-0.94), P<0.05]. At the lesion level (6 articles), the results were pooled SEN =0.96 and SPE =0.98 for PET/CT, SEN =0.76 and SPE =0.94 for SPECT. The AUC of PET/CT [0.99 (0.98-1.00)] was higher than that of SPECT [0.94 (0.92-0.96); P<0.05]. Statistical heterogeneity existed, and meta-regression showed that, at patient-based level, the study design type, tumor character, and the selection blinding method were the main sources of heterogeneity. Furthermore, both PET/CT and SPECT had superior SEN for osteogenic metastases than non-osteogenic metastases (P=0.01). At the lesion level, tumor character was a source of heterogeneity accompanied by an increased SEN for osteogenic metastases, and the SEN for SPECT combined with CT was improved [SEN =0.87 (0.68-1.00), P=0.03]. Conclusions 18F-NaF PET/CT has a higher SEN and SPE than 99mTc-MDP SPECT in diagnosing bone metastases, nevertheless, it is necessary to fully understand the primary tumor and the characteristics of the imaging protocol to choose suitable modality for individuals. Combining SPECT with CT improves the diagnostic efficacy than having SPECT alone and can be a powerful supplement to PET/CT for suspected osteogenic bone metastases.
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Affiliation(s)
- Zheng Fan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tong Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lue Zou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Da Liu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
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Wang D, Li H, Guo C, Huang S, Guo X, Xiao J. The value of 18F-NaF PET/CT in the diagnosis of bone metastases in patients with nasopharyngeal carcinoma using visual and quantitative analyses. Front Bioeng Biotechnol 2022; 10:949480. [PMID: 36091460 PMCID: PMC9449352 DOI: 10.3389/fbioe.2022.949480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022] Open
Abstract
To assess the diagnostic value of 18F-NaF PET/CT in diagnosing bone metastases in patients with nasopharyngeal carcinoma (NPC) using visual and quantitative analyses. 164 patients with NPC who underwent 18F-NaF PET/CT between 2017 and 2021 were included. The sensitivity, specificity, and accuracy were calculated. All bone lesions were divided into metastatic bone lesion group and benign lesion group; the benign lesion group was further subdivided into benign lesion without osteophyte and fracture group (CT images showing no osteophyte, no fracture), and benign lesion with osteophyte and fracture group (CT images showing typical osteophytes and fractures), the differences in maximum standardized uptake value (SUVmax) were compared between every two groups, and the diagnostic cut-off values were derived from receiver operating characteristic curves (ROC). Quantitative data were expressed as mean ± SD, multiple continuous variables were compared using one-way analysis of variance (ANOVA), and multiple comparisons among more than two groups were made using the Bonferroni method. The sensitivity, specificity, and overall accuracy of 18F-NaF PET/CT for the diagnosis of bone metastases in NPC were 97.1%, 94.6%, and 95.1% based on the patient level and 99.5%, 91.5%, and 96.4% based on the lesion level, respectively. The SUVmax was significantly different between the metastatic bone lesion group and the benign lesion without osteophyte and fracture group (p < 0.05); the area under the curve was 0.865, the threshold was 12.5, the sensitivity was 0.912, and the specificity was 0.656. Visual analysis of 18F-NaF PET/CT has high sensitivity and specificity for diagnosing bone metastases in NPC. After excluding osteophytes and fracture lesions based on CT findings, using SUVmax ≥12.5 as the threshold can be an important reference for the differential diagnosis of bone metastases and benign bone lesions in patients with NPC.
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Affiliation(s)
- Dong Wang
- Department of Nuclear Medicine (PET-CT center), Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
| | - HaiWen Li
- Cancer Center, Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
| | - ChengMao Guo
- Department of Nuclear Medicine (PET-CT center), Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
| | - Shisang Huang
- Department of Nuclear Medicine (PET-CT center), Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
| | - XuFeng Guo
- Department of Nuclear Medicine (PET-CT center), Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
| | - JingXing Xiao
- Department of Nuclear Medicine (PET-CT center), Affiliated Hospital of Guangdong Medical University, ZhangJiang, China
- *Correspondence: JingXing Xiao,
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Comparison of Bone Metastases between 18F-NaF PET/CT, 18F-NaF PET, and Planar 99mTc-MDP Bone Scintigraphy in Patients with Newly Diagnosed Nasopharyngeal Carcinoma. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5975338. [PMID: 35494210 PMCID: PMC9020896 DOI: 10.1155/2022/5975338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/26/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Abstract
Purpose Our study aims to compare the diagnostic value of 18F-NaF positron emission tomography-computed tomography (PET/CT), 18F-NaF PET, and planar 99mTc-MDP bone scintigraphy for detection of bone metastases in patients with newly diagnosed nasopharyngeal carcinoma (NPC). Methods Our study retrospectively analyzed 58 patients with pathologically proven NPC. They all underwent both 18F-NaF PET/CT and planar 99mTc-MDP bone scintigraphy within a 7-day interval. Bone metastases were confirmed by follow-up using PET/CT, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). These three examinations were compared using per-patient-based analysis and per-lesion-based analysis. Results 19 patients (32.7%) were classified as having bone metastatic disease in their final diagnosis. The patient-based diagnostic performances (sensitivity, specificity, and overall accuracy) were as follows: 18F-NaF PET/CT (100%, 92.3%, and 94.8%), 18F-NaF PET (100%, 53.8%, and 69.0%), and planar 99mTc-MDP bone scintigraphy (78.9%, 74.4%, and 75.9%). The overall accuracy of 18F-NaF PET/CT was significantly more favorable compared to 18F-NaF PET (p=0.002) and to planar 99mTc-MDP bone scintigraphy (p=0.044). The lesion-based diagnostic performances (sensitivity, specificity, and overall accuracy) were as follows: 18F-NaF PET/CT (98.5%, 93.9%, and 96.6%), 18F-NaF PET (98.5%, 57.1%, and 81.1%), and planar 99mTc-MDP bone scintigraphy (69.9%, 85.7%, and 76.4%). Conclusion 18F-NaF PET/CT outperforms 18F-NaF PET or planar 99mTc-MDP bone scintigraphy in detecting bone metastases with newly diagnosed NPC on a patient-based and lesion-based analysis.
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Kairemo K, Macapinlac HA. Oncology, bone metastases. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lee JW, Park YJ, Jeon YS, Kim KH, Lee JE, Hong SH, Lee SM, Jang SJ. Clinical value of dual-phase F-18 sodium fluoride PET/CT for diagnosing bone metastasis in cancer patients with solitary bone lesion. Quant Imaging Med Surg 2020; 10:2098-2111. [PMID: 33139990 DOI: 10.21037/qims-20-607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background The present study aimed to investigate whether dual-phase F-18 sodium-fluoride (NaF) positron emission tomography/computed tomography (PET/CT) could improve the diagnostic accuracy of detecting bone metastasis in cancer patients with a solitary bone lesion compared to conventional F-18 NaF PET/CT. Methods We retrospectively enrolled 113 cancer patients who underwent dual-phase F-18 NaF PET/CT for the differential diagnosis of a solitary bone lesion seen on bone scintigraphy. According to the dual-phase PET/CT protocol, an early-phase scan was acquired immediately after radiotracer injection and a conventional F-18 NaF PET/CT scan was performed. The diagnostic abilities of the visual analysis of conventional and dual-phase PET/CT scans and two quantitative parameters (lesion-to-blood pool uptake ratio on early-phase scan and lesion-to-bone uptake ratio on conventional scan) for detecting bone metastasis were compared. The final diagnosis of bone metastasis was made by histopathological confirmation or follow-up imaging studies. Results A metastatic bone lesion was diagnosed in 28 patients (24.8%). The sensitivity, specificity, and accuracy were 100.0%, 70.6%, and 77.9%, respectively, for visual analysis of conventional F-18 NaF PET/CT, 92.9%, 42.4%, 54.9%, respectively, for lesion-to-bone uptake ratio, 96.4%, 88.2%, and 90.3%, respectively, for visual analysis of dual-phase PET/CT, and 92.9%, 81.2%, and 83.2%, respectively, for lesion-to-blood pool uptake ratio. Visual analysis of dual-phase PET/CT was shown to have the highest area under the receiver operating characteristic curve value (0.923; 95% CI, 0.858-0.965) among all parameters. Conclusions Dual-phase F-18 NaF PET/CT showed a high diagnostic ability for detecting bone metastasis with improved specificity and accuracy compared to conventional F-18 NaF PET/CT in cancer patients. Dual-phase F-18 NaF PET/CT might help diagnose bone metastasis in patients with malignancies who were shown to have a solitary bone lesion on bone scintigraphy.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Yong-Jin Park
- Department of Nuclear Medicine, Samsung Medical Center, Seoul, Korea
| | - Youn Soo Jeon
- Department of Urology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ki Hong Kim
- Department of Urology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jong Eun Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sung Hoon Hong
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sang Mi Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Su Jin Jang
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
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Xiao J, Wang D, Guo B, Wang L, Su M, Xu H. Observer agreement and accuracy of 18F-sodium fluoride PET/computed tomography in the diagnosis of skull-base bone invasion and osseous metastases in newly diagnosed nasopharyngeal carcinoma. Nucl Med Commun 2020; 41:942-949. [PMID: 32796483 DOI: 10.1097/mnm.0000000000001243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the interobserver agreement and the diagnostic performance in F-sodium fluoride (F-NaF) PET/computed tomography (CT) for the detection of skull-base bone invasion (SBBI) and osseous metastases in patients with newly diagnosed nasopharyngeal carcinoma (NPC). METHODS One hundred seventeen patients with newly diagnosed NPC between 2017 and 2019 who underwent F-NaF PET/CT was in included. Two experienced observers independently evaluated the F-NaF PET/CT of SBBI and osseous metastases on a patient level using a two-category scale present on a dichotomous scale, respectively. On a patient level, the diagnostic performance was calculated using a sensitivity analysis. RESULTS The interobserver agreement on a patient level of SBBI and osseous metastases were perfect on a patient-level (κ: 0.85), (κ: 0.808), respectively. On a lesion level of detection of osseous metastases, the observers agreed on the number as well as the location of osseous metastases in 101 (86.3%) patients. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of detection of SBBI and osseous metastases were ranged 0.911-0.962, 0.921-0.974, 0.932-0.957, 0.962-0.986, and 0.841-0.923, and ranged 0.917-0.958, 0.899-0.957, 0.906-0.949, 0.863-0.936, and 0.939-0.970, respectively. CONCLUSION The interobserver agreement of F-NaF PET/CT for the detection of SBBI and osseous metastases in patients with NPC were both very high among trained observers. Moreover, the diagnostic performance of NaF PET/CT was satisfactory, rendering NaF PET/CT a robust tool in the diagnostic armamentarium.
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Affiliation(s)
- JingXing Xiao
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou
- Department of Nuclear Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Dong Wang
- Department of Nuclear Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Bin Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou
| | - Lu Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou
| | - Min Su
- Department of Nuclear Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hao Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou
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Targeting of radioactive platinum-bisphosphonate anticancer drugs to bone of high metabolic activity. Sci Rep 2020; 10:5889. [PMID: 32246003 PMCID: PMC7125202 DOI: 10.1038/s41598-020-62039-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/06/2020] [Indexed: 11/08/2022] Open
Abstract
Platinum-based chemotherapeutics exhibit excellent antitumor properties. However, these drugs cause severe side effects including toxicity, drug resistance, and lack of tumor selectivity. Tumor-targeted drug delivery has demonstrated great potential to overcome these drawbacks. Herein, we aimed to design radioactive bisphosphonate-functionalized platinum (195mPt-BP) complexes to confirm preferential accumulation of these Pt-based drugs in metabolically active bone. In vitro NMR studies revealed that release of Pt from Pt BP complexes increased with decreasing pH. Upon systemic administration to mice, Pt-BP exhibited a 4.5-fold higher affinity to bone compared to platinum complexes lacking the bone-seeking bisphosphonate moiety. These Pt-BP complexes formed less Pt-DNA adducts compared to bisphosphonate-free platinum complexes, indicating that in vivo release of Pt from Pt-BP complexes proceeded relatively slow. Subsequently, radioactive 195mPt-BP complexes were synthesized using 195mPt(NO3)2(en) as precursor and injected intravenously into mice. Specific accumulation of 195mPt-BP was observed at skeletal sites with high metabolic activity using micro-SPECT/CT imaging. Furthermore, laser ablation-ICP-MS imaging of proximal tibia sections confirmed that 195mPt BP co-localized with calcium in the trabeculae of mice tibia.
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Sheikhbahaei S, Jones KM, Werner RA, Salas-Fragomeni RA, Marcus CV, Higuchi T, Rowe SP, Solnes LB, Javadi MS. 18F-NaF-PET/CT for the detection of bone metastasis in prostate cancer: a meta-analysis of diagnostic accuracy studies. Ann Nucl Med 2019; 33:351-361. [PMID: 30877561 DOI: 10.1007/s12149-019-01343-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE This meta-analysis aims to establish the diagnostic performance of 18F-NaF-PET/CT for the detection of bone metastases in prostate cancer patients. The performance of 18F-NaF-PET/CT was compared with other imaging techniques in the same cohort of patients. METHODS A systematic search was performed in PubMed/Medline and EMBASE (last Updated, September 28, 2018). Studies with histopathology confirmation and/or clinical/imaging follow-up as reference standard were eligible for inclusion. RESULTS A total of 14 studies were included. Twelve studies including 507 patients provided per-patient basis information. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the summary receiver operating characteristics curve (AUC) of 18F-NaF-PET/CT for the detection of bone metastases were 0.98 (95% CI 0.95-0.99), 0.90 (95% CI 0.86-0.93), 123.2 and 0.97, respectively. Seven studies provided the lesion-based accuracy information of 1812 lesions identified on 18F-NaF-PET/CT with the pooled sensitivity, specificity, DOR and AUC of 0.97 (95% CI 0.95-0.98), 0.84 (95% CI 0.81-0.87), 206.8 and 0.97, respectively. The overall diagnostic performance of 18F-NaF-PET/CT is superior to 99mTc-bone scintigraphy (AUC 0.842; P < 0.001; four studies) and 99mTc-SPECT (AUC 0.896; P < 0.001, four studies). Compared to 18F NaF-PET/CT, whole-body MRI with diffusion-weighted imaging (DWI) was shown to have lower sensitivity (0.83, 95% CI 0.68-0.93), with no significant difference in the overall performance (AUC 0.947; P = 0.18, four studies). CONCLUSION 18F-NaF-PET/CT has excellent diagnostic performance in the detection of bone metastases in staging and restaging of high-risk prostate cancer patients. The performance of 18F-NaF-PET/CT is superior to 99mTc bone scintigraphy and SPECT, and comparable to DWI-MRI.
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Affiliation(s)
- Sara Sheikhbahaei
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Krystyna M Jones
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rudolf A Werner
- Department of Nuclear Medicine, University Hospital Wuerzburg, Würzburg, Germany
| | - Roberto A Salas-Fragomeni
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles V Marcus
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Wuerzburg, Würzburg, Germany
| | - Steven P Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lilja B Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mehrbod S Javadi
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Liu Y, Sheng J, Dong Z, Xu Y, Huang Q, Pan D, Wang L, Yang M. The diagnostic performance of 18F-fluoride PET/CT in bone metastases detection: a meta-analysis. Clin Radiol 2019; 74:196-206. [DOI: 10.1016/j.crad.2018.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
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12
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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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Löfgren J, Mortensen J, Rasmussen SH, Madsen C, Loft A, Hansen AE, Oturai P, Jensen KE, Mørk ML, Reichkendler M, Højgaard L, Fischer BM. A Prospective Study Comparing 99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with 18F-Fluoride PET/CT and 18F-Fluoride PET/MRI for Diagnosing Bone Metastases. J Nucl Med 2017; 58:1778-1785. [PMID: 28798033 DOI: 10.2967/jnumed.116.189183] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 07/11/2017] [Indexed: 12/24/2022] Open
Abstract
We prospectively evaluated and compared the diagnostic performance of 99mTc-hydroxyethylene-diphosphonate (99mTc-HDP) planar bone scintigraphy (pBS), 99mTc-HDP SPECT/CT, 18F-NaF PET/CT, and 18F-NaF PET/MRI for the detection of bone metastases. Methods: One hundred seventeen patients with histologically proven malignancy referred for clinical pBS were prospectively enrolled. pBS and whole-body SPECT/CT were performed followed by 18F-NaF PET/CT within 9 d. 18F-NaF PET/MRI was also performed in 46 patients. Results: Bone metastases were confirmed in 16 patients and excluded in 101, which was lower than expected. The number of equivocal scans was significantly higher for pBS than for SPECT/CT and PET/CT (18 vs. 5 and 6, respectively; P = 0.004 and 0.01, respectively). When equivocal readings were excluded, no statistically significant difference in sensitivity, specificity, positive predictive value, negative predictive value, or overall accuracy were found when comparing the different imaging techniques. In the per-patient analysis, equivocal scans were either assumed positive for metastases ("pessimistic analysis") or assumed negative for metastases ("optimistic analysis"). The percentages of misdiagnosed patients for the pessimistic analysis were 21%, 15%, 9%, and 7% for pBS, SPECT/CT, PET/CT, and PET/MRI, respectively. Corresponding figures for the optimistic analysis were 9%, 12%, 5%, and 7%. In those patients identified as having bone metastases according to the reference standard, SPECT/CT, 18F-NaF PET/CT, and PET/MRI detected additional lesions compared with pBS in 31%, 63%, and 71%, respectively. Conclusion:18F-NaF PET/CT and whole-body SPECT/CT resulted in a significant reduction of equivocal readings compared with pBS, which implies an improved diagnostic confidence. However, the clinical benefit of using, for example, 18F-NaF PET/CT or PET/MRI as compared with SPECT/CT and pBS in this patient population with a relatively low prevalence of bone metastases (14%) is likely limited. This conclusion is influenced by the low prevalence of patients with osseous metastases. There may well be significant differences in the sensitivity of SPECT/CT, PET/CT, and PET/MRI compared with pBS, but a larger patient population or a patient population with a higher prevalence of bone metastases would have to be studied to demonstrate this.
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Affiliation(s)
- Johan Löfgren
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jann Mortensen
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sine H Rasmussen
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Claus Madsen
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark; and
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Adam E Hansen
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Oturai
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Karl Erik Jensen
- Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mette Louise Mørk
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Michala Reichkendler
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Liselotte Højgaard
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Barbara M Fischer
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Etchebehere E, Brito AE, Rezaee A, Langsteger W, Beheshti M. Therapy assessment of bone metastatic disease in the era of 223radium. Eur J Nucl Med Mol Imaging 2017; 44:84-96. [DOI: 10.1007/s00259-017-3734-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 02/05/2023]
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15
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Jiménez Fuentes E, Arrieta Rodriguez OG, Herrera Gómez Á, Chinchilla Trigos LA. Metástasis a pulmón: manejo individualizado. GACETA MEXICANA DE ONCOLOGÍA 2016. [DOI: 10.1016/j.gamo.2016.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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