1553: The Detection of Bone Metastases by 99MTC-MDP Planar Bone Scintigraphy, Single and Multi-Field-of-Views Spect, 18F-Fluoride Pet and 18F-Fluoride Pet-CT, Prospective Study in 44 Patients with High-Risk Prostate Cancer

Even-Sapir, Einat; Metser, Ur; Mishani, Eyal; Lievshitz, Gennady; Lerman, Hedva; Leihovitch, Ilan

doi:10.1016/s0022-5347(18)33757-1

Cited by 197 publications

(303 citation statements)

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“…Obviously, there seems to be no uniform radiological criteria for assessing intercorporal fusion by plain radiographs or CT [10,[15][16][17][18]. 18F-fluoride PET/(CT) on the contrary has mostly been used in the assessment of malignant bone abnormalities [19][20][21][22][23]. However, promising results are also found in benign bone disorders, e.g.…”

Section: Discussionmentioning

confidence: 99%

Assessment of successful incorporation of cages after cervical or lumbar intercorporal fusion with [(18)F]fluoride positron-emission tomography/computed tomography

Fischer

Zweifel²,

Treyer

et al. 2010

Eur Spine J

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The purpose of this study is to assess the successful incorporation of cages in patients after cervical or lumbar intercorporal fusion with positron-emission tomography/computed tomography (PET/CT). Twenty patients (14 female and 6 male; mean age 58 years, age range 38-73 years) with 30 cervical (n = 13) or lumbar (n = 17) intercorporal fusions were prospectively enrolled in this study. Time interval between last intercorporal intervention and PET/CT ranged from 2 to 116 months (mean 63; median 77 months). IRB approval was obtained for all patients, and written informed consent was obtained from all patients. About 30 min prior to PET/CT scanning, 97-217 MBq (mean 161 MBq) 18F-fluoride were administered intravenously. Patients were imaged in supine position on a combined PET/CT system (Discovery RX/STE, 16/64 slice CT, GE Healthcare). 3D-PET emission data were acquired for 1.5 and 2 min/bed position, respectively, and reconstructed by a fully 3D iterative algorithm (VUE Point HD) using low-dose CT data for attenuation correction. A dedicated diagnostic thin-slice CT was optionally acquired covering the fused region. Areas of increased 18F-fluoride uptake around cages were determined by one double-board certified radiologist/ nuclear physician and one board certified radiologist in consensus. In 12/20 (60%) patients, increased 18F-fluoride uptake around cages was observed. Of the 30 intercorporal fusions, 15 (50%) showed increased 18F-fluoride uptake. Median time between intervention and PET/CT examination in cages with increased uptake was 37 months (2-116 months), median time between intervention and PET/CT examination in those cages without increased uptake was 91 months (19-112 months), p (Wilcoxon) = 0.01 (one-sided). 14/29 (48%) cages with a time interval [ 1 year between intervention and PET/CT scan showed an increased uptake. In conclusion, PET/CT frequently shows increased 18F-fluoride uptake in cervical and lumbar cages older than 1 year (up to almost 8 years in cervical cages and 10 years in lumbar cages) possibly indicating unsuccessful fusion due to increased stress/ microinstability.

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Section: Discussionmentioning

confidence: 99%

Assessment of successful incorporation of cages after cervical or lumbar intercorporal fusion with [(18)F]fluoride positron-emission tomography/computed tomography

Fischer

Zweifel²,

Treyer

et al. 2010

Eur Spine J

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“…25 In an analysis of planar bone scintigraphy, SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT in men with high-risk prostate cancer, the superiority of 18F-fluoride PET/CT over SPECT over bone scintigraphy was shown for both sensitivity and specificity to detect bone metastases. 26 These data suggest that whole-body MRI or 18F-flouride PET/CT may in time become the imaging modality of choice for detection and assessment of osseous metastases in prostate cancer. 27 …”

Section: Radiologic Responsementioning

confidence: 92%

Measuring therapeutic efficacy in the changing paradigm of castrate-resistant prostate cancer

Mulders

Schalken

2009

Prostate Cancer Prostatic Dis

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One of the current challenges in the evaluation of novel agents for the treatment of advanced prostate cancer is the identification of a surrogate end point for overall survival (OS). Prostatespecific antigen (PSA) levels have been used as a screening tool and a biomarker of response to both hormonal and cytotoxic agents. However, PSA levels do not seem to be a suitable surrogate end point for OS in trials of targeted agents for castrate-resistant prostate cancer (CRPC). These findings suggest the need for adopting measures of efficacy that more accurately reflect the mechanisms of action of these agents in phase II trials, in order to realize improvements in OS in the phase III setting. The Prostate Cancer Clinical Trials Working Group (PCWG2) have recently made recommendations for the design of future trials and advised that PSA levels should not be the sole criterion on which to base clinical decisions. Here, we appraise the end points that have been used in phase II and III trials in patients with CRPC, and highlight the need for the adoption of the PCWG2 guidelines, the recommendations of which include radiographic imaging, in addition to bone scintigraphy, and symptomatic or radiographic disease progression criteria.

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“…In addition it has been reported superior to X-Ray and CT [15], roughly equivalent to 11C-Choline-positron emission tomography (PET) [16] as well. Though it is inferior to whole body MRI [17] and 18F-Fluoride PET [18] but these imaging has still not able to find their way in clinical practice and associated with few limitations as well.…”

Section: Introductionmentioning

confidence: 99%

Is PSMA PET-CT Better than Bone Scan? When and Why

Gupta¹,

Choudhury²,

Goel³

et al. 2017

J Nucl Med Radiat Ther

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Prostate cancer (PCa) has a unique tropism to bone. Indeed, bone is the most frequent site of distant metastasis and cause of morbidity due to skeletal complications. 99mTc-Methylene diphosphonate (MDP) bone scintigraphy/ scan (BS) is the current standard imaging due to increase adsorption of the tracer at osteoblastic sites. However, it has limited specificity due to false positives in degenerative changes, benign causes and false negatives in bone marrow metastasis and lytic lesions. Another drawback of BS is flare response. Prostate Specific Membrane Antigen (PSMA) has been the most studies target in prostate cancer imaging in recent time due to 100-1000 time overexpression in cancer cells. 68Ga-PSMA-11, a small molecule with PSMA enzyme inhibition activity has been found promising in recurrence and lymph-node staging. In our experience of 97 staging prostate cancer patients, PSMA PET-CT showed 57.41% with pure sclerotic metastasis. Mixed (33.33%), marrow (7.14%) and lytic (2.3%) types of lesions constitute the rest and thus BS alone in these patients may leads to underestimation of bony disease burden. PSMA has not been found positive in degenerative changes however its role in response to anti-androgen needs caution due to know synergistic effect on PSMA expression. We concluded, PSMA PET-CT would have better sensitivity and specificity due to unique distinction for detecting non-sclerotic metastases. We presumed if PSMA has been performed for staging workup then there is limited role of BS except in clinical trial patient. Overall PSMA PET may become one-stop-shop for PCa workup.

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1553: The Detection of Bone Metastases by 99MTC-MDP Planar Bone Scintigraphy, Single and Multi-Field-of-Views Spect, 18F-Fluoride Pet and 18F-Fluoride Pet-CT, Prospective Study in 44 Patients with High-Risk Prostate Cancer

Cited by 197 publications

References 0 publications

Assessment of successful incorporation of cages after cervical or lumbar intercorporal fusion with [(18)F]fluoride positron-emission tomography/computed tomography

Assessment of successful incorporation of cages after cervical or lumbar intercorporal fusion with [(18)F]fluoride positron-emission tomography/computed tomography

Measuring therapeutic efficacy in the changing paradigm of castrate-resistant prostate cancer

Is PSMA PET-CT Better than Bone Scan? When and Why

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