Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer

Authors

  • Randi Fuglsang Fonager Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; ;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • Helle Damgaard Zacho Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; ;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • Niels Christian Langkilde Department of Urology, Aalborg University Hospital, Aalborg, Denmark
  • Joan Fledelius Department of Nuclear Medicine, Regional Hospital West Jutland, Herning, Denmark
  • June Anita Ejlersen Department of Nuclear Medicine, Regional Hospital West Jutland, Herning, Denmark
  • Helle Westergreen Hendel Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
  • Christian Haarmark Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
  • Mette Moe Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
  • Jesper Carl Mortensen Department of Nuclear Medicine, Regional Hospital West Jutland, Herning, Denmark
  • Mads Ryø Jochumsen Department of Urology, Regional Hospital West Jutland, Holstebro, Denmark
  • Lars Jelstrup Petersen Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; ;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

DOI:

https://doi.org/10.1080/0284186X.2018.1438651

Abstract

Aim: To compare 18F-sodium fluoride positron emission tomography/computed tomography (NaF PET/CT) and 99mTc-labelled diphosphonate bone scan (BS) for the monitoring of bone metastases in patients with prostate cancer undergoing anti-cancer treatment.

Material and methods: Data from 64 patients with prostate cancer were included. The patients received androgen-deprivation therapy (ADT), next-generation hormonal therapy (NGH) or chemotherapy. The patients had a baseline scan and 1–3 subsequent scans during six months of treatment. Images were evaluated by experienced nuclear medicine physicians and classified for progressive disease (PD) or non-PD according to the Prostate Cancer Working Group 2 (PCWG-2) criteria. The patients were also classified as having PD/non-PD according to the clinical and prostate-specific antigen (PSA) responses.

Results: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD during treatment (McNemar’s test, p = .18). The agreement between BS and NaF PET/CT for PD/non-PD was moderate (Cohen’s kappa 0.53, 95% confidence interval 0.26–0.79). Crude agreement between BS and NaF PET/CT for the assessment of PD/non-PD was 86% (89% for ADT, n = 28; 88% for NGH, n = 16, and 80% for chemotherapy, n = 20). In most discordant cases, BS found PD when NaF PET/CT did not, or BS detected PD on an earlier scan than NaF PET/CT. Biochemical progression (27%) occurred more frequently than progression on functional imaging (BS, 22% and NaF PET/CT, 14%). Clinical progression was rare (11%), and almost exclusively seen in patients receiving chemotherapy.

Conclusion: There was no difference between NaF PET/CT and BS in the detection of PD and non-PD; however, BS seemingly detects PD by the PCWG-2 criteria earlier than NaF-PET, which might be explained by the fact that NaF-PET is more sensitive at the baseline scan.

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Published

2018-08-03

How to Cite

Fuglsang Fonager, R. ., Damgaard Zacho, H. ., Christian Langkilde, N. ., Fledelius, J. ., Anita Ejlersen, J. ., Westergreen Hendel, H. ., … Jelstrup Petersen, L. . (2018). Prospective comparative study of 18F-sodium fluoride PET/CT and planar bone scintigraphy for treatment response assessment of bone metastases in patients with prostate cancer. Acta Oncologica, 57(8), 1063–1069. https://doi.org/10.1080/0284186X.2018.1438651

Issue

Vol. 57 No. 8 (2018): Acta Oncologica

Section

Articles