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

2011 ◽  
Vol 52 (9) ◽  
pp. 1009-1014 ◽  
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.

scholarly journals Higher Interrater Agreement of FDG-PET/CT than Bone Scintigraphy in Diagnosing Bone Recurrent Breast Cancer

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1021
Author(s):  
Jorun Holm ◽  
Ziba Ahangarani Farahani ◽  
Oke Gerke ◽  
Christina Baun ◽  
Kirsten Falch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Recurrent Breast Cancer ◽  
Distant Recurrence ◽  
Interrater Agreement ◽  
Whole Body ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

The purpose was to investigate the interrater agreement of FDG-PET/CT and bone scintigraphy for diagnosing bone recurrence in breast cancer patients. A total of 100 women with suspected recurrence of breast cancer underwent planar whole-body bone scintigraphy with [99mTc]DPD and FDG-PET/CT. Scans were evaluated independently by experienced nuclear medicine physicians and the results for one modality were blinded to the other. Images were visually interpreted using a 4-point assessment scale (0 = no metastases, 1 = probably no metastases, 2 = probably metastases, 3 = definite metastases). Out of 100 women, 22 (22%) were verified with distant recurrence, 18 of these had bone involvement. The proportions of agreement between readers were 93% (86.3–96.6) for bone recurrence with FDG-PET/CT and 47% (37.5–56.7) for bone recurrence with planar bone scintigraphy. The strengths of agreement between readers for diagnosing bone recurrence was ‘almost perfect’ with FDG-PET/CT and was ‘fair’ with planar bone scintigraphy according to Cohen’s kappa value of 0.82 (0.70–0.95) and 0.28 (0.18–0.39), respectively. Interrater agreement yielded improved reproducibility with FDG-PET/CT versus with bone scintigraphy when diagnosing recurrence with bone metastasis in this patient cohort.

scholarly journals Prospective comparison of the diagnostic accuracy of 18F-FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients

2021 ◽  
Author(s):  
Nils Martin Bruckmann ◽  
Julian Kirchner ◽  
Lale Umutlu ◽  
Wolfgang Peter Fendler ◽  
Robert Seifert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Primary Breast Cancer ◽  
Whole Body ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Initial Staging

Abstract Objectives To compare the diagnostic performance of [18F]FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients. Material and methods A cohort of 154 therapy-naive patients with newly diagnosed, histopathologically proven breast cancer was enrolled in this study prospectively. All patients underwent a whole-body [18F]FDG PET/MRI, computed tomography (CT) scan, and a bone scintigraphy prior to therapy. All datasets were evaluated regarding the presence of bone metastases. McNemar χ2 test was performed to compare sensitivity and specificity between the modalities. Results Forty-one bone metastases were present in 7/154 patients (4.5%). Both [18F]FDG PET/MRI and MRI alone were able to detect all of the patients with histopathologically proven bone metastases (sensitivity 100%; specificity 100%) and did not miss any of the 41 malignant lesions (sensitivity 100%). CT detected 5/7 patients (sensitivity 71.4%; specificity 98.6%) and 23/41 lesions (sensitivity 56.1%). Bone scintigraphy detected only 2/7 patients (sensitivity 28.6%) and 15/41 lesions (sensitivity 36.6%). Furthermore, CT and scintigraphy led to false-positive findings of bone metastases in 2 patients and in 1 patient, respectively. The sensitivity of PET/MRI and MRI alone was significantly better compared with CT (p < 0.01, difference 43.9%) and bone scintigraphy (p < 0.01, difference 63.4%). Conclusion [18F]FDG PET/MRI and MRI are significantly better than CT or bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. Both CT and bone scintigraphy show a substantially limited sensitivity in detection of bone metastases. Key Points • [18F]FDG PET/MRI and MRI alone are significantly superior to CT and bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. • Radiation-free whole-body MRI might serve as modality of choice in detection of bone metastases in breast cancer patients.

FDG PET-CT in breast cancer: A single institution experience from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11027-e11027
Author(s):  
Nalini K Rao ◽  
Basavalinga S Ajaikumar ◽  
Kumar G Kallur ◽  
P S Sridhar ◽  
Bhattacharjee Somorat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Treatment Plan ◽  
Whole Body ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
New Findings ◽  
Pet Ct ◽  
Fdg Pet Ct

e11027 Background: Whole body FDG PET CT is a useful tool in diagnosis, staging and prognosis; and its timely use is critical for early intervention and achieving long term survival in patients with early and advanced breast cancer. Methods: In this observational retrospective study, we report FDG PET CT findings of all breast cancer patients enrolled in our hospital based cancer registry between the years 2008 to 2011. Results: One thousand and fifty three women underwent a total of 1638 scans. Two hundred and forty five scans (14.96%) were done for staging /restaging/diagnosis, 1208 (73.75%) were for response evaluation to chemotherapy and 185 (11.29%) were for surveillance. The median age at diagnosis was 53 years. We identified a possible synchronous breast primary in 28 (2.66%) women and a probable new or existing second non-breast primary in 21(1.99%) women. Internal nodal metastasis was identified in 76 (7.21%) women at diagnosis. There were 26 (2.47%) patients with multicentric tumors. There was an increased uptake in the thyroid gland in 49(2.99%) and in the adrenal in 41 (2.50%) women. There were other random ‘Incidental findings of concern’ in 7 (0.37%) of women, diagnosed either on the CT or PET-CT component. Findings on PET-CT, including- upstaging of the breast primary and unexpected new findings, unrelated to the breast primary, changed the treatment plan in approximately 7% -10% of the patients. We did find that PET-CT did not impact early tumors; however, it did contribute in, 1) the assessment of internal mammary nodes, 2) prognostication based on tumor burden and, 3) aggressive management of oligometastases. Conclusions: Whole body FDG PET CT is a useful tool for staging and prognostication in breast cancer patients. However, the timing of such scans for surveillance needs to be defined for early detection of progression to have an impact on survival.

scholarly journals The clinical utility of FDG-PET/CT in follow up and restaging of breast cancer patients

2013 ◽  
Vol 44 (4) ◽  
pp. 937-943 ◽  
Author(s):  
Sally Emad-Eldin ◽  
Omar Abdelaziz ◽  
Marc Harth ◽  
Manar Hussein ◽  
Nour-Eldin Nour-Eldin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Clinical Utility ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Prognostic utility of FDG PET/CT and bone scintigraphy in breast cancer patients with bone-only metastasis

Medicine ◽  
2017 ◽  
Vol 96 (50) ◽  
pp. e8985 ◽  
Author(s):  
Soyeon Park ◽  
Joon-Kee Yoon ◽  
Su Jin Lee ◽  
Seok Yun Kang ◽  
Hyunee Yim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
Prognostic Utility ◽  
Fdg Pet Ct

scholarly journals Diagnosis of bone metastases in breast cancer: Lesion-based sensitivity of dual-time-point FDG-PET/CT compared to low-dose CT and bone scintigraphy

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260066
Author(s):  
Jeanette Ansholm Hansen ◽  
Mohammad Naghavi-Behzad ◽  
Oke Gerke ◽  
Christina Baun ◽  
Kirsten Falch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Low Dose ◽  
Low Dose Ct ◽  
Pet Ct ◽  
Dual Time Point ◽  
Fdg Pet Ct ◽  
Time Point

We compared lesion-based sensitivity of dual-time-point FDG-PET/CT, bone scintigraphy (BS), and low-dose CT (LDCT) for detection of various types of bone metastases in patients with metastatic breast cancer. Prospectively, we included 18 patients with recurrent breast cancer who underwent dual-time-point FDG-PET/CT with LDCT and BS within a median time interval of three days. A total of 488 bone lesions were detected on any of the modalities and were categorized by the LDCT into osteolytic, osteosclerotic, mixed morphologic, and CT-negative lesions. Lesion-based sensitivity was 98.2% (95.4–99.3) and 98.8% (96.8–99.5) for early and delayed FDG-PET/CT, respectively, compared with 79.9% (51.1–93.8) for LDCT, 76.0% (36.3–94.6) for BS, and 98.6% (95.4–99.6) for the combined BS+LDCT. BS detected only 51.2% of osteolytic lesions which was significantly lower than other metastatic types. SUVs were significantly higher for all lesion types on delayed scans than on early scans (P<0.0001). Osteolytic and mixed-type lesions had higher SUVs than osteosclerotic and CT-negative metastases at both time-points. FDG-PET/CT had significantly higher lesion-based sensitivity than LDCT and BS, while a combination of the two yielded sensitivity comparable to that of FDG-PET/CT. Therefore, FDG-PET/CT could be considered as a sensitive one-stop-shop in case of clinical suspicion of bone metastases in breast cancer patients.

Comprehensive imaging of tumor recurrence in breast cancer patients using whole-body MRI at 1.5 and 3T compared to FDG–PET–CT

2008 ◽  
Vol 65 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Gerwin P. Schmidt ◽  
Andrea Baur-Melnyk ◽  
Alexander Haug ◽  
Volker Heinemann ◽  
Ingo Bauerfeind ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Tumor Recurrence ◽  
Whole Body ◽  
Breast Cancer Patients ◽  
Whole Body Mri ◽  
Pet Ct ◽  
Fdg Pet Ct

18F-FDG PET/CT is a prognostic biomarker in patients affected by bone metastases from breast cancer in comparison with 18F-NaF PET/CT

2015 ◽  
Vol 54 (04) ◽  
pp. 163-172 ◽  
Author(s):  
A. Piccardo ◽  
M. Puntoni ◽  
S. Morbelli ◽  
F. Bongioanni ◽  
F. Paparo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Whole Body ◽  
Prognostic Impact ◽  
Disease Extent ◽  
Ki 67 ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryAim: To compare 18F-FDG PET/CT and 18F-NaF PET/CT with respect to disease prognostication and outcome in patients affected by bone metastases from breast cancer (BC). Patients, methods: We retrospectively investigated 32 women with BC and documented bone metastases. Semi-quantitative parameters were applied to 18F-FDG PET/CT and 18F-Na PET/CT in order to evaluate disease extent and tumour metabolism. We used time-to-event analyses (Kaplan Meier and COX proportional hazard methods) to estimate progression-free (PFS) and overall survival (OS) in order to assess the independent prognostic value of 18F-FDG PET/CT and 18F-Na PET/CT. Results: The sensitivity of 18F-NaF PET/CT (100%) was higher (p < 0.05) than that of 18F-FDG PET/CT (72% and 72%). None of the 18F-FDG PET/CT-negative patients showed disease progression at the end of follow-up. After adjustment for age, Ki-67 levels, presence of visceral metastases, hormone therapy, duration of bone disease and response to first-line therapy, only 18F-FDG SUV mean [HR 15.7, 95% confidence interval (CI) 1.15-214.5] and 18F-FDG whole-body bone metabolic burden (WB-B-MB) (HR 16.9; 95%CI 1.87-152.2) were independently and significantly associated with OS. None of the 18F-NaF PET/CT parameters were associated with OS. None of the conventional clinical prognostic parameters remained significantly associated with OS after the inclusion of PET/ CT parameters in the model. Conclusion: 18F-FDG PET/CT is independently associated with OS in BC patients with bone metastases and its prognostic impact seems to be higher than conventional clinical and biological prognostic factors. Although 18F-NaF PET/CT has a higher diagnostic sensitivity than 18F-FDG PET/ CT, it is not independently associated with OS.

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