title: Whole-body diffusion-weighted MRI compared with (18)F-NaF PET/CT for detection of bone metastases in patients with high-risk prostate carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the accuracy of whole-body diffusion-weighted MRI (DWI) and (18)F-NaF PET/CT for detection of bone metastases in patients with high-risk prostate cancer.
  
  
  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 (18)F-NaF PET/CT before treatment. Bone scintigraphy, conventional MR images, and follow-up images were used as the standard of reference to evaluate (18)F-NaF PET/CT and DWI.
  
  
  RESULTS
  On patient-based analysis, five patients had skeletal metastases on reference imaging that both DWI and (18)F-NaF PET/CT could verify, and (18)F-NaF PET/CT and DWI showed false-positive findings in four and one patient, respectively. With lesion-based analysis, (18)F-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, (18)F-NaF PET/CT showed more bone metastases than did DWI.
  
  
  CONCLUSIONS
  We believe (18)F-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 (18)F-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.
authors.affiliation: Department of Radiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. firas.mosavi@akademiska.se
authors.forename: Firas
authors.initials: F
authors.lastname: Mosavi
authors.forename: Silvia
authors.initials: S
authors.lastname: Johansson
authors.forename: Dan T
authors.initials: DT
authors.lastname: Sandberg
authors.forename: Ingela
authors.initials: I
authors.lastname: Turesson
authors.forename: Jens
authors.initials: J
authors.lastname: Sörensen
authors.forename: Håkan
authors.initials: H
authors.lastname: Ahlström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D016009:Chi-Square Distribution; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18