1178TiP - Prospective Evaluation of Planar Bone Scintigraphy, SPECT/CT, 18F NAF PET/CT and Whole Body 1.5T MRI for Detection of Bone Metastases in High Risk Breast and Prostate Cancer Patients

Abstract

ABSTRACT Purpose The aim of the study was to compare the diagnostic accuracy of 99mTc methylene-diphosphonate planar bone scintigraphy (99mTc-MDP BS), 99mTc methylene-diphosphonate single photon emission tomography/computed tomography (99mTc-MDP SPECT/CT), 18F NaF positron emission tomography/computed tomography (PET/CT) and whole body 1.5 Tesla magnetic resonance imaging (1.5T MRI) for the detection of bone metastases in high risk breast and prostate cancer patients. Materials and methods Twenty breast cancer patients and eight prostate cancer patients at high risk of bone metastases prospectively underwent 99mTc-MDP BS, 99mTc-MDP SPECT/CT, 18F NaF PET/CT and whole body 1.5T MRI using spine and surface coils. Four independent reviewers interpreted each individual modality without the knowledge of other imaging findings. The final metastatic status was based on the consensus reading of all imaging modalities. The findings were compared on patient and region basis. In the region based analysis, the skeleton was divided into five regions. Results Based on the consensus reading, 13 (46%) patients and 42 (30%) regions had presence of bone metastases while 15 patients and 98 regions were free of bone metastases. 99mTc-MDP BS was false negative in four patients. In the patient/region based analysis, the sensitivity for 99mTc-MDP BS, 99mTc-MDP SPECT/CT, 18F NaF PET/CT and whole body 1.5T MRI was 69%/44%, 77%/76%, 92%/90% and 77%/71%, respectively, while the accuracy was 86%/82%, 89%/92%, 96%/97% and 86%/91%, respectively. Conclusions 99mTc-MDP SPECT/CT, 18F NaF PET/CT and whole body MRI including diffusion weighted imaging demonstrated higher sensitivity and accuracy in detection of bone metastasis compared to planar bone scintigraphy. Observed difference between imaging modalities might potentially affect the patient management. Clinical relevance statement: 99mTc-MDP SPECT/CT, 18F NaF PET/CT and whole body MRI including diffusion weighted imaging showed higher sensitivity for detecting bone metastases in high risk breast and prostate cancer patients to planar bone scintigraphy. Disclosure All authors have declared no conflicts of interest.