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Vaz SC, Woll JPP, Cardoso F, Groheux D, Cook GJR, Ulaner GA, Jacene H, Rubio IT, Schoones JW, Peeters MJV, Poortmans P, Mann RM, Graff SL, Dibble EH, de Geus-Oei LF. Joint EANM-SNMMI guideline on the role of 2-[ 18F]FDG PET/CT in no special type breast cancer : (endorsed by the ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA). Eur J Nucl Med Mol Imaging 2024; 51:2706-2732. [PMID: 38740576 PMCID: PMC11224102 DOI: 10.1007/s00259-024-06696-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/20/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION There is much literature about the role of 2-[18F]FDG PET/CT in patients with breast cancer (BC). However, there exists no international guideline with involvement of the nuclear medicine societies about this subject. PURPOSE To provide an organized, international, state-of-the-art, and multidisciplinary guideline, led by experts of two nuclear medicine societies (EANM and SNMMI) and representation of important societies in the field of BC (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA). METHODS Literature review and expert discussion were performed with the aim of collecting updated information regarding the role of 2-[18F]FDG PET/CT in patients with no special type (NST) BC and summarizing its indications according to scientific evidence. Recommendations were scored according to the National Institute for Health and Care Excellence (NICE) criteria. RESULTS Quantitative PET features (SUV, MTV, TLG) are valuable prognostic parameters. In baseline staging, 2-[18F]FDG PET/CT plays a role from stage IIB through stage IV. When assessing response to therapy, 2-[18F]FDG PET/CT should be performed on certified scanners, and reported either according to PERCIST, EORTC PET, or EANM immunotherapy response criteria, as appropriate. 2-[18F]FDG PET/CT may be useful to assess early metabolic response, particularly in non-metastatic triple-negative and HER2+ tumours. 2-[18F]FDG PET/CT is useful to detect the site and extent of recurrence when conventional imaging methods are equivocal and when there is clinical and/or laboratorial suspicion of relapse. Recent developments are promising. CONCLUSION 2-[18F]FDG PET/CT is extremely useful in BC management, as supported by extensive evidence of its utility compared to other imaging modalities in several clinical scenarios.
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Affiliation(s)
- Sofia C Vaz
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal.
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | | | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - David Groheux
- Nuclear Medicine Department, Saint-Louis Hospital, Paris, France
- University Paris-Diderot, INSERM U976, Paris, France
- Centre d'Imagerie Radio-Isotopique (CIRI), La Rochelle, France
| | - Gary J R Cook
- Department of Cancer Imaging, King's College London, London, UK
- King's College London and Guy's & St Thomas' PET Centre, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute, Newport Beach, CA, USA
- University of Southern California, Los Angeles, CA, USA
| | - Heather Jacene
- Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Cancer Center Clinica Universidad de Navarra, Navarra, Spain
| | - Jan W Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-Jeanne Vrancken Peeters
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium
- University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Ritse M Mann
- Radiology Department, RadboudUMC, Nijmegen, The Netherlands
| | - Stephanie L Graff
- Lifespan Cancer Institute, Providence, Rhode Island, USA
- Legorreta Cancer Center at Brown University, Providence, Rhode Island, USA
| | - Elizabeth H Dibble
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands.
- Department of Radiation Science & Technology, Technical University of Delft, Delft, The Netherlands.
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Zamanian M, Treglia G, Abedi I. Diagnostic Accuracy of PET with Different Radiotracers versus Bone Scintigraphy for Detecting Bone Metastases of Breast Cancer: A Systematic Review and a Meta-Analysis. J Imaging 2023; 9:274. [PMID: 38132692 PMCID: PMC10744045 DOI: 10.3390/jimaging9120274] [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: 09/21/2023] [Revised: 11/05/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023] Open
Abstract
Due to the importance of correct and timely diagnosis of bone metastases in advanced breast cancer (BrC), we performed a meta-analysis evaluating the diagnostic accuracy of [18F]FDG, or Na[18F]F PET, PET(/CT), and (/MRI) versus [99mTc]Tc-diphosphonates bone scintigraphy (BS). The PubMed, Embase, Scopus, and Scholar electronic databases were searched. The results of the selected studies were analyzed using pooled sensitivity and specificity, diagnostic odds ratio (DOR), positive-negative likelihood ratio (LR+-LR-), and summary receiver-operating characteristic (SROC) curves. Eleven studies including 753 BrC patients were included in the meta-analysis. The patient-based pooled values of sensitivity, specificity, and area under the SROC curve (AUC) for BS (with 95% confidence interval values) were 90% (86-93), 91% (87-94), and 0.93, respectively. These indices for [18F]FDG PET(/CT) were 92% (88-95), 99% (96-100), and 0.99, respectively, and for Na[18F]F PET(/CT) were 96% (90-99), 81% (72-88), and 0.99, respectively. BS has good diagnostic performance in detecting BrC bone metastases. However, due to the higher and balanced sensitivity and specificity of [18F]FDG PET(/CT) compared to BS and Na[18F]F PET(/CT), and its advantage in evaluating extra-skeletal lesions, [18F]FDG PET(/CT) should be the preferred multimodal imaging method for evaluating bone metastases of BrC, if available.
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Affiliation(s)
- Maryam Zamanian
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran; (M.Z.); (I.A.)
| | - Giorgio Treglia
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
| | - Iraj Abedi
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran; (M.Z.); (I.A.)
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Vaz SC, Oliveira C, Teixeira R, Arias-Bouda LMP, Cardoso MJ, de Geus-Oei LF. The current role of nuclear medicine in breast cancer. Br J Radiol 2023; 96:20221153. [PMID: 37097285 PMCID: PMC10461286 DOI: 10.1259/bjr.20221153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 04/26/2023] Open
Abstract
Breast cancer is the most common cancer in females worldwide. Nuclear medicine plays an important role in patient management, not only in initial staging, but also during follow-up. Radiopharmaceuticals to study breast cancer have been used for over 50 years, and several of these are still used in clinical practice, according to the most recent guideline recommendations.In this critical review, an overview of nuclear medicine procedures used during the last decades is presented. Current clinical indications of each of the conventional nuclear medicine and PET/CT examinations are the focus of this review, and are objectively provided. Radionuclide therapies are also referred, mainly summarising the methods to palliate metastatic bone pain. Finally, recent developments and future perspectives in the field of nuclear medicine are discussed. In this context, the promising potential of new radiopharmaceuticals not only for diagnosis, but also for therapy, and the use of quantitative imaging features as potential biomarkers, are addressed.Despite the long way nuclear medicine has gone through, it looks like it will continue to benefit clinical practice, paving the way to improve healthcare provided to patients with breast cancer.
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Affiliation(s)
| | - Carla Oliveira
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Ricardo Teixeira
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
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Yamamoto S, Kamei S, Tomita K, Fujita C, Endo K, Hiraiwa S, Hasebe T. CT-guided bone biopsy using electron density maps from dual-energy CT. Radiol Case Rep 2021; 16:2343-2346. [PMID: 34306278 PMCID: PMC8258786 DOI: 10.1016/j.radcr.2021.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/05/2021] [Accepted: 06/06/2021] [Indexed: 10/29/2022] Open
Abstract
Computed tomography (CT) -guided bone biopsy is a diagnostic procedure performed on the musculoskeletal system with a high diagnostic yield and low complications. However, CT-guided bone biopsy has the disadvantage that it is difficult to confirm the presence of tumor cells during the biopsy procedure. Recently, the clinical benefits of dual-energy CT (DECT) over single-energy CT have been revealed. DECT can provide material decomposition images including calcium suppression images, and effective atomic number (Zeff) and electron density (ED) maps. ED maps have been reported to indicate cellularity. A 61-year-old woman with a history of breast cancer surgery was admitted to our hospital and underwent a CT-guided bone biopsy of the right ilium using ED maps. As a result, she was diagnosed with breast cancer metastases of intertrabecular bone. A comparison of ED maps with a pathological specimen revealed that high ED values occurred exclusively in the tumor area with high cellularity. This study indicates that ED maps produced using DECT may have potential utility in the accurate identification of metastases with high cellularity in bone lesions.
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Affiliation(s)
- Shota Yamamoto
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Shunsuke Kamei
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Kosuke Tomita
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Chikara Fujita
- Department of Radiological Technology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Kazuyuki Endo
- Department of Radiological Technology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Shinichiro Hiraiwa
- Department of Pathology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - Terumitsu Hasebe
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
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Taralli S, Caldarella C, Lorusso M, Scolozzi V, Altini C, Rubini G, Calcagni ML. Comparison between 18F-FDG and 18F-NaF PET imaging for assessing bone metastases in breast cancer patients: a literature review. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00363-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Bauckneht M, Capitanio S, Donegani MI, Zanardi E, Miceli A, Murialdo R, Raffa S, Tomasello L, Vitti M, Cavo A, Catalano F, Mencoboni M, Ceppi M, Marini C, Fornarini G, Boccardo F, Sambuceti G, Morbelli S. Role of Baseline and Post-Therapy 18F-FDG PET in the Prognostic Stratification of Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients Treated with Radium-223. Cancers (Basel) 2019; 12:cancers12010031. [PMID: 31861942 PMCID: PMC7016706 DOI: 10.3390/cancers12010031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Radium-223 dichloride (Ra223) represents the unique bone-directed treatment option that shows an improvement in overall survival (OS) in metastatic castrate resistant prostate cancer (mCRPC). However, there is an urgent need for the identification of reliable biomarkers to non-invasively determine its efficacy (possibly improving patients’ selection or identifying responders’ after therapy completion). 18F-Fluorodeoxyglucose (FDG)-avidity is low in naïve prostate cancer, but it is enhanced in advanced and chemotherapy-refractory mCRPC, providing prognostic insights. Moreover, this tool showed high potential for the evaluation of response in cancer patients with bone involvement. For these reasons, FDG Positron Emission Tomography (FDG-PET) might represent an effective tool that is able to provide prognostic stratification (improving patients selection) at baseline and assessing the treatment response to Ra223. We conducted a retrospective analysis of 28 mCRPC patients that were treated with Ra223 and submitted to bone scan and FDG-PET/CT for prognostic purposes at baseline and within two months after therapy completion. The following parameters were measured: number of bone lesions at bone scan, SUVmax of the hottest bone lesion, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). In patients who underwent post-therapy 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT), (20/28), PET Response Criteria in Solid Tumors (PERCIST), and European Organization for Research and Treatment of Cancer (EORTC) criteria were applied to evaluate the metabolic treatment response. The difference between end of therapy and baseline values was also calculated for Metabolic Tumor Volume (MTV), TLG, prostate-specific antigen (PSA), alkaline phosphatase (AP), and lactate dehydrogenase (LDH) (termed deltaMTV, deltaTLG, deltaPSA, deltaAP and deltaLDH, respectively). Predictive power of baseline and post-therapy PET- and biochemical-derived parameters on OS were assessed by Kaplan–Meier, univariate and multivariate analyses. At baseline, PSA, LDH, and MTV significantly predicted OS. However, MTV (but not PSA nor LDH) was able to identify a subgroup of patients with worse prognosis, even after adjusting for the number of lesions at bone scan (which, in turn, was not an independent predictor of OS). After therapy, PERCIST criteria were able to capture the response to Ra223 by demonstrating longer OS in patients with partial metabolic response. Moreover, the biochemical parameters were outperformed by PERCIST in the post-treatment setting, as their variation after therapy was not informative on long term OS. The present study supports the role of FDG-PET as a tool for patient’s selection and response assessment in mCRPC patients undergoing Ra223 administration.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Correspondence: ; Tel.: +39-0105553038; Fax: +39-0105556911
| | - Selene Capitanio
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, 16132 Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Roberto Murialdo
- Internal Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy;
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Laura Tomasello
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
| | - Martina Vitti
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Alessia Cavo
- Oncology Unit, Villa Scassi Hospital, 16149, Genova, Italy; (A.C.); (M.M.)
| | - Fabio Catalano
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (F.C.); (G.F.)
| | - Manlio Mencoboni
- Oncology Unit, Villa Scassi Hospital, 16149, Genova, Italy; (A.C.); (M.M.)
| | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy;
| | - Cecilia Marini
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Segrate (MI), Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (F.C.); (G.F.)
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, 16132 Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
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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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Abstract
OBJECTIVE The aim of this article is to present examples in which sodium fluoride labelled with 18F (NaF) bone PET/CT would be a useful adjunct to guide complex clinical decisions about the staging, restaging, and treatment approach for patients with skeletal metastases and benign causes of NaF activity that can be mistaken for bone metastases. We present a pictorial review of selected cases of this cohort of patients. CONCLUSION NaF PET/CT hybrid fusion imaging is extremely useful in identifying potential causes of pain in patients with malignancies that have an affinity for skeletal metastases. This technique can help detect bone metastases, in problem solving, and to direct appropriate management.
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Accuracy of 18F-NaF PET/CT in bone metastasis detection and its effect on patient management in patients with breast carcinoma. Nucl Med Commun 2018; 39:325-333. [DOI: 10.1097/mnm.0000000000000807] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Piva R, Ticconi F, Ceriani V, Scalorbi F, Fiz F, Capitanio S, Bauckneht M, Cittadini G, Sambuceti G, Morbelli S. Comparative diagnostic accuracy of 18F-FDG PET/CT for breast cancer recurrence. BREAST CANCER-TARGETS AND THERAPY 2017; 9:461-471. [PMID: 28740429 PMCID: PMC5503278 DOI: 10.2147/bctt.s111098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In the last decades, in addition to conventional imaging techniques and magnetic resonance imaging (MRI), 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has been shown to be relevant in the detection and management of breast cancer recurrence in doubtful cases in selected groups of patients. While there are no conclusive data indicating that imaging tests, including FDG PET/CT, produce a survival benefit in asymptomatic patients, FDG PET/CT can be useful for identifying the site of relapse when traditional imaging methods are equivocal or conflicting and for identifying or confirming isolated loco-regional relapse or isolated metastatic lesions. The present narrative review deals with the potential role of FDG PET in these clinical settings by comparing its accuracy and impact with conventional imaging modalities such as CT, ultrasound, bone scan, 18F-sodium fluoride PET/CT (18F-NaF PET/CT) as well as MRI. Patient-focused perspectives in terms of patients' satisfaction and acceptability are also discussed.
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Affiliation(s)
- Roberta Piva
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | - Flavia Ticconi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | - Valentina Ceriani
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | - Federica Scalorbi
- Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, Bologna
| | - Francesco Fiz
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | | | - Matteo Bauckneht
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | | | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS AOU San Martino - IST, Genoa, Italy
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Incremental Value of Cocktail 18F-FDG and 18F-NaF PET/CT Over 18F-FDG PET/CT Alone for Characterization of Skeletal Metastases in Breast Cancer. Clin Nucl Med 2017; 42:335-340. [PMID: 28263210 DOI: 10.1097/rlu.0000000000001615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the incremental value of cocktail F-FDG/F-NaF PET/CT over F-FDG PET/CT alone for detection of skeletal metastases in breast cancer patients. METHODS Seventy patients with locally advanced/recurrent breast cancer were prospectively included. All patients underwent whole-body F-FDG PET/CT and cocktail F-FDG/F-NaF PET/CT within a span of 1 week. Both studies were evaluated to detect presence of skeletal/marrow metastases on PET/CT images by 2 nuclear medicine physicians. Clinical and radiological correlation/follow-up was used as criterion standard. RESULTS Of 70 patients, 50 (71.0%) had locally advanced breast cancer, and 20 had recurrent breast cancer. On patient-wise analysis, both cocktail PET/CT and F-FDG PET/CT identified skeletal/marrow lesions in 23 (32.8%) of 70 patients. In 8 patients (11.4%), only cocktail PET/CT identified skeletal/marrow lesions, whereas F-FDG PET/CT was negative. In the rest of the 39 patients (55.8%), no skeletal/marrow lesion was identified on both scans. Good correlation was noted between cocktail PET/CT and F-FDG PET/CT results (r = 0.785, P < 0.0001). Cocktail PET/CT detected lesions in significantly more number of patients than F-FDG PET/CT alone (P = 0.007). On lesion-wise analysis, cocktail PET/CT detected more number of lesions in 20 patients as compared with F-FDG-PET/CT alone. Both scans detected same number of lesions in the rest of 11 patients with positive findings. A total of 32 additional lesions were identified on cocktail PET/CT imaging as compared with F PET/CT alone (P < 0.0001). CONCLUSIONS Cocktail F-FDG and F-NaF PET/CT is superior to F-FDG PET/CT alone for the detection of skeletal/marrow metastases in breast cancer. It can be a better alternative to F-FDG PET/CT alone in facilities where both tracers are available.
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