183 DETECTION OF BONE METASTASES FROM PROSTATE CANCER: A PROSPECTIVE STUDY OF 99MTC-MDP BONE SCINTIGRAPHY, 18F-FLUOROCHOLINE PET/CT, 18F-FLUORIDE PET/CT COMPARED WITH MRI

Abstract

You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2012183 DETECTION OF BONE METASTASES FROM PROSTATE CANCER: A PROSPECTIVE STUDY OF 99MTC-MDP BONE SCINTIGRAPHY, 18F-FLUOROCHOLINE PET/CT, 18F-FLUORIDE PET/CT COMPARED WITH MRI Mads Poulsen, Henrik Petersen, Poul Flemming Høilund-Carlsen, Jørn S. Jakobsen, Oke Gerke, Jens Karstoft, and Steen Walter Mads PoulsenMads Poulsen Odense, Denmark More articles by this author , Henrik PetersenHenrik Petersen Odense, Denmark More articles by this author , Poul Flemming Høilund-CarlsenPoul Flemming Høilund-Carlsen Odense, Denmark More articles by this author , Jørn S. JakobsenJørn S. Jakobsen Odense, Denmark More articles by this author , Oke GerkeOke Gerke Odense, Denmark More articles by this author , Jens KarstoftJens Karstoft Odense, Denmark More articles by this author , and Steen WalterSteen Walter Odense, Denmark More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.235AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 99mTc-MDP bone scintigraphy is the method of choice to detect bone metastasis in prostate cancer patients. However, the sensitivity and specificity of this image modality is suboptimal, and, therefore, new diagnostic tools are searched for. We examined two promising candidates, i.e., PET/CT with 18F-Fluorocholine and PET/CT with 18F-Fluoride. We compared the diagnostic value of 99mTc-MDP Bone Scintigraphy, 18F-Fluorocholine PET/CT, 18F-Fluoride PET/CT with MRI for the detection of bone metastasis in prostate cancer patients. METHODS Forty-two patients with histological confirmed prostate cancer and bone metastasis detected by 99mTc-MDP Bone scintigraphy, and no prior or active androgen deprivation were prospectively included in our study. The patients were included from April of 2009 until July 2011. The four scans were performed within a maximum of 4 weeks, in random order. The results of the scans were obtained by blinded review. In our analyses we regarded the individual bone lesions as the primary variable. MRI was our gold standard. The patients gave written and oral consent and the study was approved by our local ethics committee. RESULTS The mean age of the patients was 73.2 years (range 53-92). The median PSA level was 77.0 (range 4-5740). The average Gleason score was 7.6 (range 2-10). A total of 431 bone lesions were found in 42 patients, 283 lesions were rated as malignant according to MRI. Results by the three other methods are seen in the table: 99mTc-MDP WB Bone Scintigraphy 18F-Fluoride PET/CT 18F-Choline PET/CT Sensitivity (95% CI) 36.4%(22.4%,50.4%) 92.9%(88.3%,97.6%) 87.5%(76.8%,98.3%) Specificity (95% CI) 81.8%(72.5%,91.0%) 50.0%(32.3%,67.7%) 89.9%(81.2%,98.5%) Positive predictive value (95% CI) 79.2%(63.7%,94.8%) 78.5%(65.7%,91.4%) 94.5%(89.6%,99.3%) Negative predictive value (95% CI) 40.2%(25.3%,55.1%) 78.3%(65.7%,90.9%) 78.5%(61.9%,95.1%) CONCLUSIONS Our results suggest that 18F-Choline PET/CT is superior to both 18F-Fluoride PET/CT and 99mTc-MDP bone scintigraphy with regard to detection of bone metastasis in patients with prostate cancer. In addition, 99mTc-MDP bone scintigraphy, although less expensive, is not optimal for the primary detection of metastatic bone decease in hormone native patients with prostate cancer. It raises the question on whether the conventional 99mTc-MDP whole-body bone scintigraphy is the image modality of choice if 18F-Choline PET/CT is available. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e77 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mads Poulsen Odense, Denmark More articles by this author Henrik Petersen Odense, Denmark More articles by this author Poul Flemming Høilund-Carlsen Odense, Denmark More articles by this author Jørn S. Jakobsen Odense, Denmark More articles by this author Oke Gerke Odense, Denmark More articles by this author Jens Karstoft Odense, Denmark More articles by this author Steen Walter Odense, Denmark More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...