68Ga-FAPI PET/CT detected non-FDG-avid bone metastases in breast cancer

Objective. To determine the value of 18F-FDG PET/CT in detection of bone marrow (BM) metastasis in breast cancer which is considered an early stage of bone metastasis. Patients and Methods. Retrospectively, breast cancer patients with bone metastasis were included. BM metastasis was considered if the lesion was PET positive/CT occult while bone metastasis was considered if the lesion was PET positive/ CT positive. BM metastases were observed sequentially on F18-FDG PET/CT. Results. We included 35 patients. Eighteen patients (51%) had BM metastases in addition to other bone metastases. BM metastases comprised 24% of all lesions. Posttreatment scan was performed on 26/35 patients. Twenty-three percent of BM metastases had resolved completely without causing bone destruction after treatment. Sixty-five percent of BM metastases had converted into bone metastases after treatment. Twelve percent of BM metastases had persisted after treatment. Conclusion. This retrospective study showed clinically by 18F-FDG PET/CT imaging that BM metastasis is an early stage of bone metastasis in breast cancer. Interestingly, 18F-FDG-PET/CT showed that early eradication of individual BM metastasis by systemic treatment precluded development of bone metastasis. However, more research is needed to study the impact of an early diagnosis of BM metastases on treatment outcome.

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Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan?

Revista Española de Medicina Nuclear e Imagen Molecular ◽

10.1016/j.remn.2015.08.006 ◽

2016 ◽

Vol 35 (1) ◽

pp. 3-11 ◽

Cited By ~ 3

Author(s):

M. Caglar ◽

O. Kupik ◽

E. Karabulut ◽

P.F. Høilund-Carlsen

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Scan ◽

Breast Cancer Patients ◽

Pet Ct

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P36 Assessment of bone metastases using bone scan and PET/CT imaging in patients with breast cancer

The Breast ◽

10.1016/s0960-9776(07)70101-7 ◽

2007 ◽

Vol 16 ◽

pp. S22

Author(s):

Y.H. Lee ◽

H.Y. Park ◽

Y.S. Lim ◽

J.H. Jung ◽

D.H. Cho ◽

...

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Bone Scan ◽

Ct Imaging ◽

Pet Ct

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Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

Acta Radiologica ◽

10.1258/ar.2011.100507 ◽

2011 ◽

Vol 52 (9) ◽

pp. 1009-1014 ◽

Cited By ~ 46

Author(s):

Steffen Hahn ◽

Till Heusner ◽

Sherko Kümmel ◽

Angelika Köninger ◽

James Nagarajah ◽

...

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Bone Scintigraphy ◽

Fdg Pet ◽

Whole Body ◽

Reference Standard ◽

Breast Cancer Patients ◽

Pet Ct ◽

Fdg Pet Ct

Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion-basis whole-body FDG-PET/CT is more sensitive and equally specific for the detection of bone metastases compared with bone scintigraphy.

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