scholarly journals Multiple Metastasis-Like Bone Lesions in Scintigraphic Imaging

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ying Zhang ◽  
Chunlei Zhao ◽  
Hongbiao Liu ◽  
Haifeng Hou ◽  
Hong Zhang
Keyword(s):  
Bone Metastases ◽  
Eosinophilic Granuloma ◽  
Clinical Work ◽  
Whole Body ◽  
Bone Lesions ◽  
Osteolytic Lesions ◽  
Multiple Imaging ◽  
Imaging Results ◽  
Multiple Bone Metastases ◽  
Treatment Procedures

Multiple benign osteolytic lesions are very hard to differentiate from disseminated bone metastasis. Whole-body bone scintigraphy (WBBS) with technetium-99m methylene diphosphonate (Tc-99m MDP) demonstrates multiple lesions with increased uptake in any bone involved. Even combined with medical history and multiple imaging results, such as MRI and CT, the clinical diagnosis of metastasis lesion remains as a challenge. These clinical characteristics are similar to multiple malignant bone metastases and therefore affect the following treatment procedures. In this paper, we analyzed multiple benign osteolytic lesions, like eosinophilic granuloma (EG), multiple myeloma (MM), disseminated tuberculosis, fibrous dysplasia, or enchondroma, occurring in our daily clinical work and concluded that additional attention should be paid before giving the diagnosis of multiple bone metastases.

scholarly journals Radionuclide Bone Scintigraphy: An Interesting Case Report

2015 ◽  
Vol 17 (1) ◽  
pp. 111-115
Author(s):  
Mohana Hossain ◽  
Hosne Ara Rahman ◽  
Mahbubul Haque ◽  
Mahbubur Rahman ◽  
Md Sanowar Hossain ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Eosinophilic Granuloma ◽  
Metastatic Lesion ◽  
Interesting Case ◽  
Whole Body ◽  
Osteolytic Lesions ◽  
Multiple Imaging ◽  
Imaging Results

It is well established that Technetium99mmethylene diphosphonate (Tc99m MDP) whole body bone scintigraphy (WBBS) can demonstrate multiple lesions with increased radiotracer concentration in involved bone. But it is hard to differentiate multiple benign osteolytic lesions from disseminated bone metastases. Even combined with medical history and multiple imaging results, clinical diagnosis of metastatic lesion remains a challenge. This can affect the treatment procedure. Here the role of skeletal scintigraphy in a case of eosinophilic granuloma is evaluated and concluded that additional attention should be given before diagnosing any case as bone metastases. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22502 Bangladesh J. Nuclear Med. 17(1): 111-115, January 2014

Treatment of bone metastases with dichloromethylene bisphosphonate.

1992 ◽  
Vol 10 (4) ◽  
pp. 591-598 ◽  
Author(s):  
G Francini ◽  
S Gonnelli ◽  
R Petrioli ◽  
F Conti ◽  
P Paffetti ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Serum Alkaline Phosphatase ◽  
Urinary Calcium ◽  
Bone Lesions ◽  
Osteolytic Lesions ◽  
Concurrent Use ◽  
Pathologic Fractures ◽  
Group A ◽  
Group B

PURPOSE The study was undertaken to evaluate the effects of dichloromethylene bisphosphonate (Cl2MDP) on osteolytic and osteoblastic bone lesions from a variety of tumoral primary sites and to investigate the in vivo mechanism underlying the action of this drug. PATIENTS AND METHODS Seventy-six patients participated in the current study: 59 had predominantly osteolytic lesions and 17 osteoblastic metastases. Sixteen patients had hypercalcemia. All of the patients received 300 mg of Cl2MDP intravenously (IV) for 7 days and then 200 mg of Cl2MDP intramuscularly (IM) for 14 days. Biochemical parameters were measured in the patients before the start of treatment and 3, 7, 14, and 21 days after beginning treatment. After the withdrawal of parenteral Cl2MDP, 59 patients with predominantly osteolytic lesions were then randomized to receive chemotherapy alone (group A, 29 cases) or chemotherapy plus Cl2MDP given at an oral dose of 1,200 mg/d (group B, 30 cases). RESULTS Serum calcium (Ca), urinary calcium (UCa) phosphate (UPO4), and hydroxyproline (HOP) excretion levels significantly decreased in all patients, whereas no significant changes occurred in serum alkaline phosphatase (AlkPh) and bone Gla-protein (BGP) levels. In 56 patients with painful bone lesions, a progressive analgesic effect was observed mainly between day 7 and day 14. In patients with predominantly osteoblastic metastases, the Cl2MDP treatment led to a more evident hypocalcemia and an increase in both AlkPh and BGP. However, in the majority of these patients the hypocalcemia was corrected by the concurrent use of effective cytotoxic treatments capable of reducing osteoblast stimulation. During 6 months of follow-up, two pathologic fractures occurred in patients of group A, and none occurred in patients of group B. CONCLUSIONS We conclude that Cl2MDP was effective in patients presenting bone metastases with and without hypercalcemia. Care should be taken particularly in those patients with mixed metastases when the sclerotic component is predominant, as the drug may enhance the possibility of hypocalcemia, which is generally corrected by effective cytotoxic drugs. Therefore, Cl2MDP can be considered a valuable support in the treatment of bone metastases.

scholarly journals 68Ga-P15-041, A Novel Bone Imaging Agent for Diagnosis of Bone Metastases

2021 ◽  
Vol 11 ◽  
Author(s):  
Rui Guo ◽  
Xiangxi Meng ◽  
Fei Wang ◽  
Jiangyuan Yu ◽  
Qing Xie ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Whole Body ◽  
Bone Lesions ◽  
Pet Ct ◽  
Patlak Analysis ◽  
Parametric Maps

Objectives68Ga-P15-041 (68Ga-HBED-CC-BP) is a novel bone-seeking PET radiotracer, which can be readily prepared by using a simple kit formulation and an in-house 68Ga/68Ge generator. The aim of this study is to assess the potential human application of 68Ga-P15-041 for clinical PET/CT imaging and to compare its efficacy to detect bone metastases of different cancers with 99mTc-MDP whole-body bone scintigraphy (WBBS).MethodsInitial kinetic study using Patlak analysis and parametric maps were performed in five histopathologically proven cancer patients (three males, two females) using 68Ga-P15-041 PET/CT scan only. Another group of 51 histopathologically proven cancer patients (22 males, 29 females) underwent both 99mTc-MDP WBBS and 68Ga-P15-041 PET/CT scans within a week, sequentially. Using either pathology examination or follow-up CT or MRI scans as the gold standard, the diagnostic efficacy and receiver operating characteristic curve (ROC) of the two methods in identifying bone metastases were compared (p <0.05, statistically significant).ResultsFifty-one patients were imaged, and 174 bone metastatic sites were identified. 68Ga-P15-041 PET/CT and 99mTc-MDP WBBS detected 162 and 81 metastases, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 68Ga-P15-041 PET/CT and 99mTc-MDP WBBS were 93.1% vs 81.8%, 89.8% vs 90.7%, 77.5% vs 69.2%, 97.2% vs 93.4% and 90.7% vs 88.4%, respectively. Our results showed that the mean of SUVmax was significantly higher in metastases than that in benign lesions, 15.1 ± 6.9 vs. 5.6 ± 1.3 (P <0.001). Using SUVmax = 7.6 as the cut-off value by PET/CT, it was possible to predict the occurrence of metastases (AUC = 0.976; P <0.001; 95% CI: 0.946–0.999). However, it was impossible to distinguish osteoblastic bone metastases from osteolytic bone lesions. Parametric maps based on Patlak analysis provided excellent images and highly valuable quantitative information.Conclusions68Ga-P15-041 PET/CT, offering a rapid bone scan and high contrast images in minutes, is superior to the current method of choice in detecting bone metastases. It is reasonable to suggest that 68Ga-P15-041 PET/CT could become a valuable routine nuclear medicine procedure in providing excellent images for detecting bone metastases in cancer patients. 68Ga-P15-041 could become a valuable addition expanding the collection of 68Ga-based routine nuclear medicine procedures where 18F fluoride is not currently available.

scholarly journals Correcting B0 inhomogeneity-induced distortions in whole-body diffusion MRI of bone metastases

2020 ◽  
Author(s):  
Leonardino A. Digma ◽  
Christine H. Feng ◽  
Christopher C. Conlin ◽  
Ana E. Rodríguez-Soto ◽  
Kanha Batra ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Bone Lesion ◽  
Distortion Correction ◽  
Whole Body ◽  
Bone Lesions ◽  
Thoracic Vertebrae ◽  
Signed Rank ◽  
Spatial Displacements ◽  
T2 Weighted Images

AbstractBackgroundAccurate imaging of bone metastases is necessary for treatment planning and assessing treatment response. Diffusion-weighted magnetic resonance imaging (DWI) can detect bone metastases, but DWI acquired with echo-planar imaging is susceptible to distortions due to static magnetic field inhomogeneities.PurposeEstimate spatial displacements of bone lesions on DWI. Examine whether distortion-corrected DWI more accurately reflects underlying anatomy.Study TypeRetrospective.Subjects18 patients with prostate cancer bone metastases.Field Strength/Sequence3.0 T; DWI and T2-weighted imaging.AssessmentWe first applied the reverse polarity gradient (RPG) technique to estimate spatial displacements of bone metastasis on DWI. Next, we calculated changes in mutual information (MI) between DWI and T2-weighted images after RPG distortion correction. Further, we annotated skeletal landmarks on DWI and T2-weighted images. RPG was again used to estimate displacements of these landmarks. Lastly, we calculated changes in distance between DWI- and T2-defined landmarks (i.e., changes in error) after RPG distortion correction.Statistical TestsMean and bootstrap-derived confidence intervals were used to summarize variables that estimate bone lesion distortions. Wilcoxon signed-rank tests were used to assess change in MI between DWI and T2-weighted images after RPG.ResultsMean (95% CI) displacement of bone lesions was 5.6 mm (95% CI: 4.8-6.5); maximum displacement was 17.1 mm. Corrected diffusion images were more similar to structural MRI, as evidenced by consistent increases in MI after applying RPG (Wilcoxon signed-rank p<10−13). Like bone metastases, our annotated skeletal landmarks also underwent substantial displacement (average, 6.3 mm). Lastly, RPG led to consistent error reductions between DWI and T2 for each skeletal landmark (mean, [95% CI]): thoracic vertebrae (−3.8 mm, [-4.3,-3.3]), abdominal vertebrae (−1.0 mm, [-1.2,-0.71]), pelvic vertebrae (−0.6 mm, [-1.0,-0.17]), and femoral head (−1.2 mm, [-2.1,-0.4]).Data ConclusionsThese findings support the use of distortion correction techniques to improve localization of bone metastases on DWI.Grant SupportThis work was supported by NIH/NIBIB #K08EB026503, American Society for Radiation Oncology, and the Prostate Cancer Foundation. This work was further supported by the National Institute on Aging T35 grant AG26757 (PI: Dilip V. Jeste, MD, and Alison Moore, MD, MPH), and the Stein Institute for Research on Aging and the Center for Healthy Aging at the University of California, San Diego.

Bone metastases in patients with gastrinomas: a prospective study of bone scanning, somatostatin receptor scanning, and magnetic resonance image in their detection, frequency, location, and effect of their detection on management.

1998 ◽  
Vol 16 (3) ◽  
pp. 1040-1053 ◽  
Author(s):  
F Gibril ◽  
J L Doppman ◽  
J C Reynolds ◽  
C C Chen ◽  
V E Sutliff ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Liver Metastases ◽  
Bone Metastases ◽  
Bone Scan ◽  
Somatostatin Receptor ◽  
Axial Skeleton ◽  
Bone Lesions ◽  
Endocrine Tumors ◽  
Bone Scanning ◽  
Imaging Results

PURPOSE To determine whether bone scan, magnetic resonance imaging (MRI), or somatostatin receptor scintigraphy (SRS) is best for identifying bone metastases in patients with gastrinomas, as well as their frequency and location, whether their detection affects management, and what patient subgroups should be examined. MATERIALS AND METHODS One hundred fifteen patients with gastrinoma were prospectively studied. Patients were examined yearly and those with liver metastases were reexamined every 3 months. Based on clinical history, histology, growth pattern, and development of new bone lesions, possible bone metastases were classified as to whether they were or were not bone metastases. Imaging results were correlated at different times in the disease course and with disease extent. RESULTS Bone scan was positive in 52 patients, MRI in seven, and SRS in six. Eight patients (7%) were determined to have bone metastases and MRI was correctly positive in seven, SRS in six, and bone scan in five. SRS or MRI was positive in all patients with bone metastases. Bone scan had significantly lower specificity and sensitivity, and a higher rate (P < .02) of false-negative results than MRI or SRS. Bone metastases occurred in 31% of patients with liver metastases and 0% with only lymph node metastases. The initial bone metastases were in the spine or sacrum (75%) followed in descending order by the pelvis or sacroiliac joints (38%), scapula or shoulder, and ribs. In all cases, detection of bone metastases changed the management. CONCLUSION SRS and MRI, because of high sensitivity and specificity, are recommended over bone scanning to screen for bone metastases in patients with gastrinomas. However, because bone metastases can occur initially outside the axial skeleton, SRS is the recommended initial localization method of choice. Bone metastases occur in 7% of all patients and 31% of patients with liver metastases, only occur in patients with liver metastases, are usually in the axial skeleton initially, and their detection changes management in all cases. Patients with pancreatic endocrine tumors with liver metastases should undergo SRS every 6 months to 1 year to detect bone metastases.

scholarly journals Eosinophilic Granuloma: Bilateral Temporal Bone Involvement

2007 ◽  
Vol 86 (6) ◽  
pp. 342-343 ◽  
Author(s):  
Chester P. Barton ◽  
Drew Horlbeck
Keyword(s):  
Temporal Bone ◽  
Eosinophilic Granuloma ◽  
Disease Process ◽  
Bone Involvement ◽  
Bone Lesions ◽  
Osteolytic Lesions ◽  
The Past ◽  
Uncommon Condition

Eosinophilic granuloma is an uncommon condition that is characterized by unifocal or multifocal osteolytic lesions that often affect the skull. Unilateral lesions of the temporal bone are not uncommon, but bilateral temporal bone lesions are rare. In fact, to the best of our knowledge, fewer than 20 such cases have been reported during the past 40 years. We report a new case of bilateral temporal bone eosinophilic granuloma, and we review the disease process and its treatment.

The EOS® System for the Detection of Bone Lesions in Patients with Multiple Myeloma,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3921-3921
Author(s):  
Bastien Dutouquet ◽  
Xavier Leleu ◽  
Antoine Moraux ◽  
Eileen Boyle ◽  
Jordan Gauthier ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Radiation Dose ◽  
Imaging Techniques ◽  
Response To Therapy ◽  
Whole Body ◽  
Bone Lesions ◽  
Osteolytic Lesions ◽  
Lytic Lesions

Abstract Abstract 3921 Background. Osteolytic disease is a major complication of multiple myeloma (MM) that may lead to devastating skeletal-related events (SREs). 70% of patients have osteolytic lesions at diagnosis, and up to 90% develop lytic lesions during the course of their disease. Furthermore, almost 15% of patients present with diffuse osteopenia at diagnosis. Various imaging techniques have been performed for the diagnosis and follow-up of bone disease in MM, however, conventional radiography (CR) remains the gold standard. CR has several limitations. One is that CR reveals lytic disease when more than 30% of the trabecular bone has been lost. Thus, some patients may have a suboptimal assessment of generalized osteopenia. Another limitation is that CR cannot be used for the assessment of response to therapy because the lytic bone lesions seldom show evidence of healing. On the other hand new vertebral fractures do not always indicate disease progression and may occur due to ongoing bone loss or reduction of tumor mass that supports the bony cortex. Other limitations include lack of accurate visualization of some areas, observer dependency, lengthy period on the examination table, and poor tolerance by patients with severe pain and extended lytic disease. The EOS System is a new 2D and 3D imaging system for musculo-skeletal physiology and pathology assessment with low radiation dose and standing position. We hypothesized that EOS would not be inferior to CR in terms of routine imaging and diagnosis of bone lytic lesions of patients with MM, but would improve on the quality of life during the procedure of the imaging for the frail patients with MM. Methods and Materials. Fifty six consecutive patients with symptomatic MM (at diagnostic and at first relapse) were included in this prospective study. Each patient provided informed consent. All patients underwent an EOS® examination (frontal and lateral views from skull to knees) and radiographs (axial skeleton: skull, spine, pelvis, femurs, humeri, ribs, as per International Myeloma Working Group guidelines) the same day, prior to start any treatment. Each imaging modality was read in random order by 2 reviewers independently for the detection of bone lesions (osteolytic lesions, vertebral collapses). Whole-body MRI was performed in case of disagreement between the 2 imaging modalities. Radiation dose and technical comfort were also assessed. The length of time of either exam was measured and the patients had to fill in a quality of life questionnaire aimed at comparing the roughness of the 2 techniques. Our study received prior approval from our Ethics Committee. Results. The median age was 62 (range, 32–90), gender ratio was 30 male / 26 female. CR and EOS® diagnosed 467 and 451 bone lytic lesions, respectively. There was no significant difference between the 2 imaging techniques, as 445 out of 473 bone lesions were detected by both the EOS®system and the CR. The median length of time to perform the CR exam was 6 to 8 times longer than EOS® technique. The average radiation dose with the EOS®system was 7.8 times less than with CR. The majority of the patients found the EOS®system examination to be more comfortable than the multiple radiographic incidences. The main limitation to EOS® technique was in patients with high BMI greater than 30, in whom CR remains the most sensitive technique. Furthermore, EOS® system was not able to differentiate old versus novel lytic lesions, as expected with standard radiographs. Finally, EOS presented with the same difficulty to count the number of lytic lesions per patient, as for the CR technique. Conclusion. EOS® system is a new low-dose radiation device which allows a quicker scan of the whole body. In this preliminary study performed in patients with MM, this technique allowed detection of bone lesions with better comfort for the patients as compared to CR. This is of paramount importance in patients with MM that often presented with altered health status and bone pain that hampered the ability to perform CR with optimal conditions. Disclosures: Facon: Celgene: Consultancy, Honoraria; Janssen-Cilag: Consultancy, Honoraria.

Osseous metastases of gastro- entero - pancreatic neuroendocrine tumours

2012 ◽  
Vol 51 (03) ◽  
pp. 95-100 ◽  
Author(s):  
F. Heinemann ◽  
S. Guhlke ◽  
M. Muckle ◽  
W. Willinek ◽  
H.-J. Biersack ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Functional Imaging ◽  
Peptide Receptor Radionuclide Therapy ◽  
Rank Test ◽  
Bone Lesions ◽  
Time To Progression ◽  
Effective Treatment Option ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Imaging Results

SummaryAim: Peptide receptor radionuclide therapy with 177Lu-octreotate is an effective treatment option for metastatic gastroenteropancreatic neuroendocrine tumors (GEP NET) and allows intratherapeutic imaging through a 177Lu-octreotate scan (LuS). The diagnostic value of this treatment scan is not yet established. This study aims to compare the sensitivity of LuS and bone scintigraphy (BS) regarding bone metastases and investigate potential implications of functional imaging results. Patients, methods: We retrospectively analyzed 29 consecutive GEP NET patients with bone metastases and baseline BS treated with 177Lu-octreotate. A semi-quantitative scoring system was used for the comparative evaluation. Treatment outcome (time-to-progression of bone metastases) was correlated with the intra-individual imaging discrepancy (Kaplan- Meyer curves, log-rank test, p < 0.05). Results: In 19 of 29 patients (65.5%) LuS was superior (LuS > BS), whereas in 10 patients (34.5%) both modalities were comparable. BS showed no additional (LuS-negative) metastatic bone lesions in our cohort. None of the investigated baseline characteristics was associated with Imaging discrepancy. On the other hand, functional imaging discrepancy had no impact on treatment response (p = 0.43) or time-to-progression (p = 0.92). Conclusions: Intra-therapeutic 177Lu-octreotate imaging is superior over bone scintigraphy for detection of bone metastases in GEP NET. BS may help to distinguish osseous from non-osseous localization. The presence of an osteoblastic correlate in BS seems to have no impact on therapeutic outcome

scholarly journals Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography

2021 ◽  
Vol 11 ◽  
Author(s):  
Daniela E. Oprea-Lager ◽  
Matthijs C.F. Cysouw ◽  
Ronald Boellaard ◽  
Christophe M. Deroose ◽  
Lioe-Fee de Geus-Oei ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Metastases ◽  
Bone Lesion ◽  
Response Assessment ◽  
Emission Tomography ◽  
Whole Body ◽  
Bone Lesions ◽  
Cancer Type ◽  
Current Response ◽  
Positron Emission

Metastatic tumor deposits in bone marrow elicit differential bone responses that vary with the type of malignancy. This results in either sclerotic, lytic, or mixed bone lesions, which can change in morphology due to treatment effects and/or secondary bone remodeling. Hence, morphological imaging is regarded unsuitable for response assessment of bone metastases and in the current Response Evaluation Criteria In Solid Tumors 1.1 (RECIST1.1) guideline bone metastases are deemed unmeasurable. Nevertheless, the advent of functional and molecular imaging modalities such as whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography (PET) has improved the ability for follow-up of bone metastases, regardless of their morphology. Both these modalities not only have improved sensitivity for visual detection of bone lesions, but also allow for objective measurements of bone lesion characteristics. WB-MRI provides a global assessment of skeletal metastases and for a one-step “all-organ” approach of metastatic disease. Novel MRI techniques include diffusion-weighted imaging (DWI) targeting highly cellular lesions, dynamic contrast-enhanced MRI (DCE-MRI) for quantitative assessment of bone lesion vascularization, and multiparametric MRI (mpMRI) combining anatomical and functional sequences. Recommendations for a homogenization of MRI image acquisitions and generalizable response criteria have been developed. For PET, many metabolic and molecular radiotracers are available, some targeting tumor characteristics not confined to cancer type (e.g. 18F-FDG) while other targeted radiotracers target specific molecular characteristics, such as prostate specific membrane antigen (PSMA) ligands for prostate cancer. Supporting data on quantitative PET analysis regarding repeatability, reproducibility, and harmonization of PET/CT system performance is available. Bone metastases detected on PET and MRI can be quantitatively assessed using validated methodologies, both on a whole-body and individual lesion basis. Both have the advantage of covering not only bone lesions but visceral and nodal lesions as well. Hybrid imaging, combining PET with MRI, may provide complementary parameters on the morphologic, functional, metabolic and molecular level of bone metastases in one examination. For clinical implementation of measuring bone metastases in response assessment using WB-MRI and PET, current RECIST1.1 guidelines need to be adapted. This review summarizes available data and insights into imaging of bone metastases using MRI and PET.

Intraindividual comparison of [11C]acetate and [11C]choline PET for detection of metastases of prostate cancer

2003 ◽  
Vol 42 (01) ◽  
pp. 25-30 ◽  
Author(s):  
B. G. Volkmer ◽  
G. Glatting ◽  
J. van den Hoff ◽  
J. E. Gschwend ◽  
P. Messer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Bone Metastases ◽  
Primary Tumour ◽  
Lymph Node Involvement ◽  
Interindividual Variation ◽  
Whole Body ◽  
Bone Lesions ◽  
Node Involvement

AbstractIn a pilot trial we investigated whether significant differences in prostate cancer (PCA) imaging would be observed using [11C]acetate and [11C]choline positron emission tomography (PET). Methods: Twelve patients were studied with both radiotracers. Whole body PET without attenuation correction was performed after injection of 0.95 ± 0.15 GBq [11C]acetate and 0.84 ± 0.13 GBq [11C]choline, respectively, from 5 to 60 min p. i. Focally increased uptake in bone, below the urinary bladder or in a lymph node region was considered as tumour. Primary tumour, lymph node involvement, bone metastases, local recurrence; and no evidence of disease were known in 2, 4, 2, 2; and 2 patients, respectively. Results: [11C]Acetate uptake was highest in spleen and pancreas while [11C]choline uptake was predominant in liver and kidney parenchyma. However, interindividual variation was high. The potential of both radiotracers to detect known bone lesions, lymph node metastases, and imaging of the primary tumour was identical. However, both failed to detect a small local recurrence in two patients as well as to demonstrate lymph node involvement in one patient, which was confirmed by surgery. Conclusions: In this preliminary study, uptake of both radiotracers in prostate cancer or its metastases was nearly identical and none of them should be favoured. At present, both radiotracers influence patient management by detection of local recurrence, lymph node, or bone metastases of PCA.

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