OBJECTIVE: The purpose of this study was to evaluate the accuracy of whole-body diffusion-weighted MRI (DWI) and 18F-NaF PET/CT for detection of bone metastases in patients with high-risk prostate cancer.
SUBJECTS AND METHODS: Both patient- and lesion-based analyses were performed on 49 consecutive patients (median age, 67 years; age range, 57-80 years) with recently diagnosed high-risk prostate cancer. All patients underwent bone scintigraphy, whole-body MRI including DWI and 18F-NaF PET/CT before treatment. Bone scintigraphy, conventional MR images, and follow-up images were used as the standard of reference to evaluate 18F-NaF PET/CT and DWI.
RESULTS: On patient-based analysis, five patients had skeletal metastases on reference imaging that both DWI and 18F-NaF PET/CT could verify, and 18F-NaF PET/CT and DWI showed false-positive findings in four and one patient, respectively. With lesion-based analysis, 18F-NaF PET/CT and DWI showed nine and five true-positive lesions, zero and four false-negative lesions, and seven and two false-positive lesions, respectively. Two patients with uncountable bone metastases were analyzed separately. In these patients, 18F-NaF PET/CT showed more bone metastases than did DWI.
CONCLUSION: We believe 18F-NaF PET/CT is a sensitive modality for detection of bone metastases caused by prostate cancer. Whole-body DWI shows a higher specificity but lower sensitivity than 18F-NaF PET/CT. Future studies with a larger patient cohort along with analyses of costs and clinical availability are needed before implementation of these methods can be considered.
Written by:
Mosavi F, Johansson S, Sandberg DT, Turesson I, Sörensen J, Ahlström H. Are you the author?
Department of Radiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
Reference: AJR Am J Roentgenol. 2012 Nov;199(5):1114-20.
doi: 10.2214/AJR.11.8351
PubMed Abstract
PMID: 23096187
UroToday.com Prostate Cancer Section
