OBJECTIVE: Determination of the accuracy of sodium fluorine-18-fluoride (F-NaF) PET/computed tomography (CT) for the evaluation of bone metastases, and the impact on patient management in breast cancer patients. PATIENTS AND METHODS: Patients with breast cancer, referred for F-NaF PET/CT between February 2014 and June 2016, were included in a database. Baseline characteristics, clinical indication, definitive diagnosis according to follow-up data, as well as changes in patient management were recorded. Follow-up was performed during a period of at least 6 months using histopathologic, medical imaging, biochemical, and clinical data. RESULTS: A total of 118 patients were included in the study. Indications for F-NaF PET/CT included primary staging (12%), follow-up (31%), bone pain (52%), abnormal laboratory findings (5%), and evaluation of equivocal osseous lesions on other imaging modalities (3%). Bone metastases were found in 42%, whereas 53% of the scans were negative and 5% yielded equivocal results. Correlation with the reference standard yielded a sensitivity of 0.96, a specificity of 0.91, a positive predictive value of 0.89, a negative predictive value of 0.97, and an accuracy of 0.93. In 25% of the patients, the scan results led to alterations in patient management. F-NaF PET/CT for the evaluation of bone pain showed no explanation in 29%, benign pathology in 66%, and bone metastases in 5%. CONCLUSION: In the present cohort of patients with breast cancer, F-NaF PET/CT detected bone metastases in 42% with an accuracy of 0.93. The scan results led to a change in patient management in 25%. In the evaluation of bone pain, an explanation for pain was found in 71% of the scans.
OBJECTIVE: Determination of the accuracy of sodium fluorine-18-fluoride (F-NaF) PET/computed tomography (CT) for the evaluation of bone metastases, and the impact on patient management in breast cancerpatients. PATIENTS AND METHODS: Patients with breast cancer, referred for F-NaF PET/CT between February 2014 and June 2016, were included in a database. Baseline characteristics, clinical indication, definitive diagnosis according to follow-up data, as well as changes in patient management were recorded. Follow-up was performed during a period of at least 6 months using histopathologic, medical imaging, biochemical, and clinical data. RESULTS: A total of 118 patients were included in the study. Indications for F-NaF PET/CT included primary staging (12%), follow-up (31%), bone pain (52%), abnormal laboratory findings (5%), and evaluation of equivocal osseous lesions on other imaging modalities (3%). Bone metastases were found in 42%, whereas 53% of the scans were negative and 5% yielded equivocal results. Correlation with the reference standard yielded a sensitivity of 0.96, a specificity of 0.91, a positive predictive value of 0.89, a negative predictive value of 0.97, and an accuracy of 0.93. In 25% of the patients, the scan results led to alterations in patient management. F-NaF PET/CT for the evaluation of bone pain showed no explanation in 29%, benign pathology in 66%, and bone metastases in 5%. CONCLUSION: In the present cohort of patients with breast cancer, F-NaF PET/CT detected bone metastases in 42% with an accuracy of 0.93. The scan results led to a change in patient management in 25%. In the evaluation of bone pain, an explanation for pain was found in 71% of the scans.
Authors: Jeong Won Lee; Yong-Jin Park; Youn Soo Jeon; Ki Hong Kim; Jong Eun Lee; Sung Hoon Hong; Sang Mi Lee; Su Jin Jang Journal: Quant Imaging Med Surg Date: 2020-11
Authors: Jeong Won Lee; Shi Nae Yu; Ik Dong Yoo; Min Hyok Jeon; Chang-Hwa Hong; Jai-Joon Shim; Sung-Hae Chang; Sang Mi Lee Journal: Medicine (Baltimore) Date: 2019-03 Impact factor: 1.817