Comparison of 18 F-NaF PET/CT with Other Imaging Methods in the Detection of Bone Metastases in Patients with Medullary
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ORIGINAL ARTICLE
Comparison of 18F-NaF PET/CT with Other Imaging Methods in the Detection of Bone Metastases in Patients with Medullary Thyroid Cancer: a Report of a Series of 31 Cases Cristina Emiko Ueda 1 & Paulo Schiavom Duarte 1 & Luciana Audi de Castroneves 2 & George Barbério Coura-Filho 1 & Heitor Naoki Sado 1,3 & Marcelo Tatit Sapienza 3 & Ana Oliveira Hoff 2 & Carlos Alberto Buchpiguel 1,3 Received: 1 July 2020 / Revised: 21 August 2020 / Accepted: 18 September 2020 # Korean Society of Nuclear Medicine 2020
Abstract Purpose To compare the 18F-NaF PET/CT studies (18F-NaF) with other imaging methods in the detection of skeletal metastases (SM) in patients with medullary thyroid cancer (MTC). Methods We retrospectively analyzed 31 patients with MTC who performed 18F-NaF to assess SM. The results of the 18F-NaF were compared with other imaging methods performed for metastasis detection: 99Tc-MDP bone scan (BS), magnetic resonance imaging (MRI), contrast-enhanced CT (CT), and 68Ga-Dotatate and 18F-FDG PET/CT studies. A qualitative analysis comparing the 18F-NaF findings with the ones of the other methods was performed, and the results were classified as superior (>), equal (=), and inferior ( BS and in 3 18F-NaF = BS), 1 performed 18 F-FDG (18F-NaF > 18F-FDG), 4 performed 68Ga-Dotatate (in 2 18F-NaF > 68Ga-Dotatate and in 2 18F-NaF = 68Ga-Dotatate), 20 performed CT of at least one body segment (in 15 18F-NaF = CT and in 5 18F-NaF > CT), and 16 performed MRI of at least one body segment, and in all of them, the 18F-NaF was equal to the MRI. Beside this, the 18F-NaF detected SM in body segments not routinely scanned in MRI and CT. Conclusion In patients with MTC, the 18F-NaF seems to be equal or superior to other imaging modalities in the detection of SM and allows the analysis of the whole skeletal in a single study. Keywords Fluorine . 18F . PET/CT . 18F-NaF . Medullary thyroid carcinoma . Bone metastases
Introduction The 18F-NaF PET/computed tomography (CT) study has been used for bone metastasis detection in a variety of neoplastic diseases, mainly those with osteoblastic lesions [1–3]. In
* Paulo Schiavom Duarte [email protected] 1
Division of Nuclear Medicine, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
2
Division of Endocrinology, São Paulo Cancer Institute (ICESP), São Paulo, Brazil
3
Division of Nuclear Medicine, Department of Radiology and Oncology, Medical School of University of São Paulo (FMUSP), São Paulo, Brazil
this application, it has a higher level of accuracy than Tc-labeled diphosphonate scintigraphy (bone scan), even when using SPECT and SPECT/CT techniques [4–6]. This higher accuracy of the 18F-NaF PET/CT in association with the increased availability of PET/CT equipment [7, 8] and with the episodic shortages of technetium-99m production [9] is leading to the growing use of the 18F-NaF PET/CT in the daily practice. Medullary thyroid cancer (MTC) is a rare thyroid tumor originating from the parafollicular C cells [10]. These cells secrete calcitonin [11] that is an impo
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