Prospective comparative study of18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer.

To compare18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.

Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1-3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.

There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar's test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen's kappa 0.53, 95% confidence interval 0.26-0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.

There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

Acta oncologica (Stockholm, Sweden). 2018 Feb 15 [Epub ahead of print]

Randi Fuglsang Fonager, Helle Damgaard Zacho, Niels Christian Langkilde, Joan Fledelius, June Anita Ejlersen, Helle Westergreen Hendel, Christian Haarmark, Mette Moe, Jesper Carl Mortensen, Mads Ryø Jochumsen, Lars Jelstrup Petersen

a Department of Nuclear Medicine , Clinical Cancer Research Center, Aalborg University Hospital , Aalborg , Denmark., c Department of Urology , Aalborg University Hospital , Aalborg , Denmark., d Department of Nuclear Medicine , Regional Hospital West Jutland , Herning , Denmark., e Department of Clinical Physiology and Nuclear Medicine , Herlev Hospital , Herlev , Denmark., f Department of Oncology , Aalborg University Hospital , Aalborg , Denmark., g Department of Urology , Regional Hospital West Jutland , Holstebro , Denmark.


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.