Combined 18F-Fluoride and 18F-FDG PET/CT scanning for evaluation of malignancy: Results of an international multicenter trial
Journal of Nuclear Medicine
Stanford University Medical Center, Stanford, CA, United States; Pretoria University Hospital, Pretoria, South Africa; Aalborg University Hospital, Aalborg, Denmark; Serviço de Medicina Nuclear, Hospitais da Universidade de Coimbra, Coimbra, Portugal; Departments of Radiology, Bioengineering, Materials Science, and Engineering, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, United States; Division of Nuclear Medicine, Stanford University Medical Center, 300 Pasteur Dr., Room H-0101, Stanford, CA 94305, United States
18F-FDG PET/CT is used in a variety of cancers, but because of variable rates of glucose metabolism, not all cancers are reliably identified. 18F- PET/CT allows for the acquisition of highly sensitive and specific images of the skeleton. We prospectively evaluated combined 18F-/18F-FDG as a single PET/CT examination for evaluation of cancer patients and compared it with separate 18F - PET/CT and 18F-FDG PET/CT scans. Methods: One hundred fifteen participants with cancer were prospectively enrolled in an international multicenter trial evaluating 18F- PET/CT, 18F-FDG PET/CT, and combined 18F-/ 18F-FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F-/ 18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease was more extensive on 18F- PET/CT and 18F -/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F- PET/CT and 18F-/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial demonstrated that combined 18F-/18F-FDG PET/CT shows promising results when compared with separate 18F- PET/CT and 18F-FDG PET/CT for evaluation of cancer patients. This result opens the possibility for improved patient care and reduction in health-care costs, as will be further evaluated in future trials. Copyright © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
fluorine 18; fluorodeoxyglucose f 18; diagnostic agent; fluorine; glucose; adult; aged; article; bone metastasis; cancer invasion; cancer patient; cancer staging; clinical evaluation; computer assisted emission tomography; controlled study; diagnostic accuracy; diagnostic imaging; diagnostic test accuracy study; dosimetry; female; human; image analysis; major clinical study; male; malignant neoplastic disease; multicenter study; outcome assessment; patient assessment; priority journal; prospective study; radiation dose distribution; bone; bone tumor; clinical trial; computer assisted tomography; image processing; international cooperation; metabolism; metastasis; methodology; middle aged; neoplasm; nuclear medicine; oncology; pilot study; positron emission tomography; reproducibility; scintiscanning; Adult; Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Glucose; Humans; Image Processing, Computer-Assisted; International Cooperation; Male; Medical Oncology; Middle Aged; Neoplasm Metastasis; Neoplasms; Nuclear Medicine; Pilot Projects; Positron-Emission Tomography; Prospective Studies; Reproducibility of Results; Tomography, X-Ray Computed