Prospective study evaluating the relative sensitivity of 18F-NaF PET/CT for detecting skeletal metastases from renal cell carcinoma in comparison to multidetector CT and 99mTc-MDP bone scintigraphy, using an adaptive trial design

Abstract

Current imaging techniques for detecting bone metastases in renal carcinoma are insensitive to small lesions. This prospective trial of 18F-NaF PET/CT shows it is more than twice as sensitive as CT and more than three times as sensitive as bone scintigraphy for these lesions. 18F-NaF PET/CT could alter management by identifying occult metastases in patients with negative standard-of-care imaging.

Imaging biomarker roadmap for cancer studies

“…Similarly, group-sequential design127 can provide flexibility in the number of animals or patients entered into a study. Such approaches can ensure adequate power with small sample sizes — if effect sizes are suitably large — and, therefore, can make imaging studies more affordable128.…”

A retrospective study of SPECT/CT scans using SUV measurement of the normal pelvis with Tc-99m methylene diphosphonate

“…However, few of these QIBs are used routinely in clinical trials or clinical care [11,12]. Quantitative analyses have been performed for bone scans of vertebrae using the standardized uptake value (SUV) as QIB of SPECT/CT scans with 99m Tc-MDP [8,13]. SUV is defi ned as the tissue concentration of tracer as measured by a positron emission tomography (PET) scanner divided by the activity concentration injected divided usually by body weight methylene diphosphonate.…”

“…The pelvis in the most common localization after spine in bone metastasis [3]. The detection of occult bone metastases is a key factor in determining the management of patients with cancer, which can greatly alter patient management [13]. 99m Tc-MDP bone scans showed hot spots in the lower lumbar region of the spine and/or the pelvic bone [17], it was diffi cult to identify bone metastases in the early stages by visual evaluation.…”

Canadian Urological Association guideline for followup of patients after treatment of non-metastatic renal cell carcinoma

“…However, 18 F-Sodium fluoride PET-CT may have an advantage over conventional modalities in bone and musculoskeletal metastases. It is more sensitive at detecting RCC skeletal metastases than bone scintigraphy or CT. 71,72 Currently, PET-CT is not a standard exam for diagnosis, staging, or surveillance in RCC.…”