A1 Journal article – refereed
Prospective evaluation of planar bone scintigraphy, SPECT, SPECT/CT, 18F-NaF PET/CT and whole body 1.5T MRI, including DWI, for the detection of bone metastases in high risk breast and prostate cancer patients: SKELETA clinical trial




List of Authors: Ivan Jambor, Anna Kuisma, Susan Ramadan, Riikka Huovinen, Minna Sandell, Sami Kajander, Jukka Kemppainen, Esa Kauppila, Joakim Auren, Harri Merisaari, Jani Saunavaara, Tommi Noponen, Heikki Minn, Hannu J. Aronen, Marko Seppänen
Publication year: 2016
Journal: Acta Oncologica
Volume number: 55
Issue number: 1
Number of pages: 9
eISSN: 1651-226X

Abstract

Purpose.
Detection of bone metastases in breast and prostate cancer patients
remains a major clinical challenge. The aim of the current trial was to
compare the diagnostic accuracy of 99mTc-hydroxymethane diphosphonate (99mTc-HDP) planar bone scintigraphy (BS), 99mTc-HDP SPECT, 99mTc-HDP SPECT/CT, 18F-NaF
PET/CT and whole body 1.5 Tesla magnetic resonance imaging (MRI),
including diffusion weighted imaging, (wbMRI+DWI) for the detection of
bone metastases in high risk breast and prostate cancer patients.

Material and methods. Twenty-six breast and 27 prostate cancer patients at high risk of bone metastases underwent 99mTc-HDP BS, 99mTc-HDP SPECT, 99mTc-HDP SPECT/CT, 18F-NaF
PET/CT and wbMRI+DWI. Five independent reviewers interpreted each
individual modality without the knowledge of other imaging findings. The
final metastatic status was based on the consensus reading, clinical
and imaging follow-up (minimal and maximal follow-up time was 6, and 32
months, respectively). The bone findings were compared on patient-,
region-, and lesion-level.

Results. 99mTc-HDP BS was false negative in four patients. In the region-based analysis, sensitivity values for 99mTc-HDP BS, 99mTc-HDP SPECT, 99mTc-HDP SPECT/CT, 18F-NaF PET/CT, and wbMRI+DWI were 62%, 74%, 85%, 93%, and 91%, respectively. The number of equivocal findings for 99mTc-HDP BS, 99mTc-HDP SPECT, 99mTc-HDP SPECT/CT, 18F-NaF PET/CT and wbMRI+DWI was 50, 44, 5, 6, and 4, respectively.

Conclusion. wbMRI+DWI showed similar diagnostic accuracy to 18F-NaF PET/CT and outperformed 99mTc-HDP SPECT/CT, and 99mTc-HDP BS.


Last updated on 2019-22-03 at 16:25

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