title: FDG-avid sclerotic bone metastases in breast cancer patients: a PET/CT case series.
abstract: Distant metastases from breast cancer most frequently occur in the skeleton. Although 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), with or without computed tomography (CT), is superior to bone scintigraphy for the detection of osteolytic bone metastases, it has been reported that sclerotic bone metastases frequently show no or only a low degree of FDG uptake on PET and PET/CT. Since both lytic and sclerotic metastases can occur in breast cancer patients, bone scintigraphy may remain of additional value in these patients. In this case series, we describe four breast cancer patients in whom FDG PET/CT has clearly visualized sclerotic bone metastases because of increased FDG uptake. Not so much the type of metastasis (sclerotic or lytic), but possibly the characteristics of the primary tumor or treatments prior to the FDG PET/CT scan might influence the degree of FDG uptake of bone metastases. The ability to detect sclerotic bone metastases based on increased FDG uptake supports the use of FDG PET/CT as a staging procedure in breast cancer patients, but knowledge of factors determining the visibility of bone metastases with FDG PET/CT is crucial.
authors.affiliation: Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. b.koolen@nki.nl
authors.forename: Bas B
authors.initials: BB
authors.lastname: Koolen
authors.forename: Erik
authors.initials: E
authors.lastname: Vegt
authors.forename: Emiel J Th
authors.initials: EJ
authors.lastname: Rutgers
authors.forename: Wouter V
authors.initials: WV
authors.lastname: Vogel
authors.forename: Marcel P M
authors.initials: MP
authors.lastname: Stokkel
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Hoefnagel
authors.forename: Annemarie
authors.initials: A
authors.lastname: Fioole-Bruining
authors.forename: Marie-Jeanne T F D
authors.initials: MJ
authors.lastname: Vrancken Peeters
authors.forename: Renato A
authors.initials: RA
authors.lastname: Valdés Olmos
mesh_terms: D000328:Adult; D001692:Biological Transport; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18