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.

Initial [18F]FDG PET/CT in high-risk DTC patients

2016 ◽  
Vol 55 (03) ◽  
pp. 99-103 ◽  
Author(s):  
Ina Binse ◽  
Andreas Bockisch ◽  
Sandra Rosenbaum-Krumme ◽  
Marcus Ruhlmann
Keyword(s):  
High Risk ◽  
Fdg Pet ◽  
Patient Management ◽  
Whole Body ◽  
Prognostic Impact ◽  
Full Remission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryIn a previous paper, we published the impact of initial [18F]FDG PET/CT (FDG-PET/CT) in high-risk patients with differentiated thyroid cancer (DTC) and described the changes in therapy management. The aim of the present study was to evaluate the prognostic impact of the initial FDG-PET/CT on a patient’s follow-up over three years and the rate of complete remission. Patients, methods: This study included 109 DTC patients who underwent radioiodine treatment (RIT), including posttherapeutic whole-body scintigraphy with FDG-PET/CT and a follow-up over three years. The follow-up included high-resolution sonography of the neck and determination of serum Tg as well as Tg antibodies every six months. The results of initial FDG-PET/CT and whole-body scintigraphy were compared with the status after three years of follow-up. Results: 24/109 patients (22%) presented FDG-positive lesions, 22/109 patients (20%) only iodine-positive lesions, and 63/109 patients (58%) neither FDG-positive nor iodine-positive lesions. After three years, 83/109 patients (76%) revealed full remission, 15/109 patients (14%) tumour persistence and 11/109 patients (10%) a progressive disease. The negative predictive value (NPV) was calculated for patients without FDG-positive lesions (NPV 85%) and patients without any lesions (NPV 91%) regarding full remission in the follow-up. Conclusion: FDG-PET/CT has a high NPV (85% to 91%) in DTC patients regarding recurrence-free follow-up after three years. The change in patient management in patients with iodine-negative lesions can lead to a higher rate of full remissions in the follow-up after additional surgery. Therefore, FDG-PET/ CT should be performed in all high-risk DTC patients in the context of the first RIT to improve patient management and risk stratification.

scholarly journals Bone Marrow Metastasis Is an Early Stage of Bone Metastasis in Breast Cancer Detected Clinically by F18-FDG-PET/CT Imaging

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Kusai M. Al-Muqbel
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Early Stage ◽  
Ct Imaging ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

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.

scholarly journals Lyme Neuroborreliosis in a Patient with Breast Cancer: MRI and PET/CT Findings

Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 36
Author(s):  
Mathilde Ørbæk ◽  
Camilla Klausen ◽  
Anne-Mette Lebech ◽  
Helene Mens
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Cauda Equina ◽  
Lyme Neuroborreliosis ◽  
Foot Drop ◽  
Whole Body ◽  
Nuclear Medicine Imaging ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

We present a case demonstrating the performance of different radiographical and nuclear medicine imaging modalities in the diagnostic work-up of a patient with Lyme neuroborreliosis. The patient presented in late summer 2019 with radicular pains followed by a foot drop and peripheral facial palsy, both right-sided. Due to a history of breast cancer, disseminated malignant disease was initially suspected. Bone metastasis was ruled out by skeletal scintigraphy. Magnetic resonance imaging (MRI) of the neuroaxis and a whole body 18F-FDG PET-CT was performed within 48 hours. The MRI revealed a strong contrast enhancement of the conus medullaris and fibers of the cauda equina, while the 18F-FDG PET/CT was without pathological findings. Examination of cerebrospinal fluid led to the definitive diagnosis of Lyme neuroborreliosis with monocytic pleocytosis and a positive intrathecal test for Borrelia burgdorferi. The patient became pain-free after 10 days of ceftriaxone, and the paralysis slowly regressed the following month. This case highlights the difficulty of the diagnosis of Lyme neuroborreliosis and discusses the relevant imaging findings.

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 Detection of Ureteral Stump Transitional Cell Carcinoma, Presenting as Bone Metastases from Unknown Primary by 18F-FDG PET/CT: A Case Report with Review of Literature

2022 ◽  
Author(s):  
Petya N. Nikolova ◽  
Valeria H. Hadzhiyska ◽  
Kiril B. Mladenov ◽  
Mihaela G. Ilcheva ◽  
Stefani Veneva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Transitional Cell ◽  
Pain Syndrome ◽  
Whole Body ◽  
Unknown Primary ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

AbstractA case of occult carcinoma of the ureteral stump is reported. A 67-year-old man presented with pain syndrome due to multiple bone metastases from unknown primary origin detected by previous imaging studies as magnetic resonance imaging, whole body contrast-enhanced computed tomography (CT), and technetium-99m methyldiphosphonate bone scan. He had undergone a right nephrectomy for a benign disease previously. He was referred to our department for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to help localize possible primary tumor. Our observations in this case show that the use of 18F-FDG PET/CT successfully and more accurately evaluated the overall tumor burden and led to a rapid decision of an adequate therapeutic approach.

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