TY - JOUR
T1 - Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer
AU - Fonager, Randi Fuglsang
AU - Zacho, Helle Damgaard
AU - Langkilde, Niels Christian
AU - Fledelius, Joan
AU - Ejlersen, June Anita
AU - Hendel, Helle Westergreen
AU - Haarmark, Christian
AU - Moe, Mette
AU - Mortensen, Jesper Carl
AU - Jochumsen, Mads Ryø
AU - Petersen, Lars Jelstrup
PY - 2018/8/3
Y1 - 2018/8/3
N2 - AIM: 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.MATERIAL AND METHODS: 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.RESULTS: 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.CONCLUSION: 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.
AB - AIM: 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.MATERIAL AND METHODS: 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.RESULTS: 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.CONCLUSION: 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.
KW - Aged
KW - Aged, 80 and over
KW - Bone Neoplasms/diagnostic imaging
KW - Fluorine Radioisotopes
KW - Humans
KW - Male
KW - Middle Aged
KW - Positron Emission Tomography Computed Tomography/methods
KW - Prospective Studies
KW - Prostatic Neoplasms/drug therapy
KW - Radionuclide Imaging/methods
KW - Radiopharmaceuticals
KW - Sodium Fluoride
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85042071368&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2018.1438651
DO - 10.1080/0284186X.2018.1438651
M3 - Journal article
C2 - 29447047
SN - 0284-186X
VL - 57
SP - 1063
EP - 1069
JO - Acta Oncologica
JF - Acta Oncologica
IS - 8
ER -