Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases

Andrei Iagaru, Phillip Young, Erik Mittra, David W. Dick, Robert Herfkens, Sanjiv Sam Gambhir

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: The aim of this study was to compare 99mTc-MDP bone scanning, 18F NaF PET/CT, 18F FDG PET/CT, and whole-body MRI (WBMRI) for detection of known osseous metastases. Patients and Methods: This prospective pilot trial (September 2007-April 2009) enrolled 10 participants (5 men, 5 women, 47Y81 years old) diagnosed with cancer and known osseous metastases. 18F NaF PET/CT, 18F FDG PET/CT, and WBMRI were performed within 1 month for each participant. Results: The image quality and evaluation of extent of disease were superior by 18F NaF PET/CT compared to 99mTc-MDP scintigraphy in all patients with skeletal lesions and compared to 18F FDG PET/CT in 3 of the patients with skeletalmetastases. 18F NaF PET/CT showed osseousmetastaseswhere 18FFDG PET/CT was negative in another 3 participants. Extraskeletal metastases were identified by 18F FDG PET/CT in 6 participants. WBMRI with the combination of iterative decomposition of water and fat with echo asymmetry and leastsquares estimation, short tau inversion recovery, and diffusion-weighted imaging pulse sequences showed fewer lesions than 18F NaF PET/CT in 5 patients, same number of lesions in 2 patients, and more lesions in 1 patient. WBMRI showed fewer lesions than 18F FDG in 3 patients and same lesions in 6 patients. Conclusions: Our pilot phase prospective trial demonstrated superior image quality and evaluation of skeletal disease extent with 18F NaF PET/CT compared to 99mTc-MDP scintigraphy and 18F FDGPET/CT, aswell as the feasibility of multisequence WBMRI. In addition, 18F FDG PET/CT provided valuable soft-tissue information that can change disease management. Further evaluation of these findings using the recently introduced PET/MRI scanners is warranted.

Original languageEnglish (US)
JournalClinical Nuclear Medicine
Volume38
Issue number7
DOIs
StatePublished - Jul 2013

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Technetium Tc 99m Medronate
Fluorodeoxyglucose F18
Radionuclide Imaging
Neoplasm Metastasis
Disease Management
Fats
Bone and Bones
Water

Keywords

  • F FDG
  • F NaF
  • Tc-MDP
  • PET/CT
  • WBMRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases. / Iagaru, Andrei; Young, Phillip; Mittra, Erik; Dick, David W.; Herfkens, Robert; Gambhir, Sanjiv Sam.

In: Clinical Nuclear Medicine, Vol. 38, No. 7, 07.2013.

Research output: Contribution to journalArticle

Iagaru, Andrei ; Young, Phillip ; Mittra, Erik ; Dick, David W. ; Herfkens, Robert ; Gambhir, Sanjiv Sam. / Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases. In: Clinical Nuclear Medicine. 2013 ; Vol. 38, No. 7.
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AU - Young, Phillip

AU - Mittra, Erik

AU - Dick, David W.

AU - Herfkens, Robert

AU - Gambhir, Sanjiv Sam

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AB - Objective: The aim of this study was to compare 99mTc-MDP bone scanning, 18F NaF PET/CT, 18F FDG PET/CT, and whole-body MRI (WBMRI) for detection of known osseous metastases. Patients and Methods: This prospective pilot trial (September 2007-April 2009) enrolled 10 participants (5 men, 5 women, 47Y81 years old) diagnosed with cancer and known osseous metastases. 18F NaF PET/CT, 18F FDG PET/CT, and WBMRI were performed within 1 month for each participant. Results: The image quality and evaluation of extent of disease were superior by 18F NaF PET/CT compared to 99mTc-MDP scintigraphy in all patients with skeletal lesions and compared to 18F FDG PET/CT in 3 of the patients with skeletalmetastases. 18F NaF PET/CT showed osseousmetastaseswhere 18FFDG PET/CT was negative in another 3 participants. Extraskeletal metastases were identified by 18F FDG PET/CT in 6 participants. WBMRI with the combination of iterative decomposition of water and fat with echo asymmetry and leastsquares estimation, short tau inversion recovery, and diffusion-weighted imaging pulse sequences showed fewer lesions than 18F NaF PET/CT in 5 patients, same number of lesions in 2 patients, and more lesions in 1 patient. WBMRI showed fewer lesions than 18F FDG in 3 patients and same lesions in 6 patients. Conclusions: Our pilot phase prospective trial demonstrated superior image quality and evaluation of skeletal disease extent with 18F NaF PET/CT compared to 99mTc-MDP scintigraphy and 18F FDGPET/CT, aswell as the feasibility of multisequence WBMRI. In addition, 18F FDG PET/CT provided valuable soft-tissue information that can change disease management. Further evaluation of these findings using the recently introduced PET/MRI scanners is warranted.

KW - F FDG

KW - F NaF

KW - Tc-MDP

KW - PET/CT

KW - WBMRI

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