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Cook GJR, Thorpe MP. Bone Metastases. Cancer J 2024; 30:202-209. [PMID: 38753755 DOI: 10.1097/ppo.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
ABSTRACT Bone metastases occur frequently in common malignancies such as breast and prostate cancer. They are responsible for considerable morbidity and skeletal-related events. Fortunately, there are now several systemic, focal, and targeted therapies that can improve quality and length of life, including radionuclide therapies. It is therefore important that bone metastases can be detected as early as possible and that treatment can be accurately and sensitively monitored. Several bone-specific and tumor-specific single-photon emission computed tomography and positron emission tomography molecular imaging agents are available, for detection and monitoring response to systemic therapeutics, as well as theranostic agents to confirm target expression and predict response to radionuclide therapies.
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Affiliation(s)
- Gary J R Cook
- From the Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, UK
| | - Matthew P Thorpe
- Division of Nuclear Radiology, Department of Radiology, Mayo Clinic, Rochester, MN
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Ouvrard E, Kaseb A, Poterszman N, Porot C, Somme F, Imperiale A. Nuclear medicine imaging for bone metastases assessment: what else besides bone scintigraphy in the era of personalized medicine? Front Med (Lausanne) 2024; 10:1320574. [PMID: 38288299 PMCID: PMC10823373 DOI: 10.3389/fmed.2023.1320574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Accurate detection and reliable assessment of therapeutic responses in bone metastases are imperative for guiding treatment decisions, preserving quality of life, and ultimately enhancing overall survival. Nuclear imaging has historically played a pivotal role in this realm, offering a diverse range of radiotracers and imaging modalities. While the conventional bone scan using 99mTc marked bisphosphonates has remained widely utilized, its diagnostic performance is hindered by certain limitations. Positron emission tomography, particularly when coupled with computed tomography, provides improved spatial resolution and diagnostic performance with various pathology-specific radiotracers. This review aims to evaluate the performance of different nuclear imaging modalities in clinical practice for detecting and monitoring the therapeutic responses in bone metastases of diverse origins, addressing their limitations and implications for image interpretation.
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Affiliation(s)
- Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Ashjan Kaseb
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
- Radiology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Nathan Poterszman
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Clémence Porot
- Radiopharmacy, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Francois Somme
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
- IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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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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Paravastu SS, Hasani N, Farhadi F, Collins MT, Edenbrandt L, Summers RM, Saboury B. Applications of Artificial Intelligence in 18F-Sodium Fluoride Positron Emission Tomography/Computed Tomography:: Current State and Future Directions. PET Clin 2021; 17:115-135. [PMID: 34809861 DOI: 10.1016/j.cpet.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This review discusses the current state of artificial intelligence (AI) in 18F-NaF-PET/CT imaging and the potential applications to come in diagnosis, prognostication, and improvement of care in patients with bone diseases, with emphasis on the role of AI algorithms in CT bone segmentation, relying on their prevalence in medical imaging and utility in the extraction of spatial information in combined PET/CT studies.
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Affiliation(s)
- Sriram S Paravastu
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 1C455, Bethesda, MD 20892, USA; Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health (NIH), 30 Convent Dr., Building 30, Room 228 MSC 4320, Bethesda, MD 20892, USA
| | - Navid Hasani
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 1C455, Bethesda, MD 20892, USA; University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA 70121, USA
| | - Faraz Farhadi
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 1C455, Bethesda, MD 20892, USA; Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Michael T Collins
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health (NIH), 30 Convent Dr., Building 30, Room 228 MSC 4320, Bethesda, MD 20892, USA
| | - Lars Edenbrandt
- Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Ronald M Summers
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 1C455, Bethesda, MD 20892, USA
| | - Babak Saboury
- Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 1C455, Bethesda, MD 20892, USA; Department of Computer Science and Electrical Engineering, University of Maryland- Baltimore County, Baltimore, MD, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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