title: The value of quantitative analysis in18F-NaF PET/CT.
abstract: OBJECTIVE
  To evaluate the ability of SUVmax to differentiate bone metastases from degenerative lesions, blastic from lytic metastases, as well as to determine the correlation between SUVmax with18F-NaF and with18F-FDG.
  
  
  METHODS
  A review was performed on 11518F-NaF PET/CT studies. Of the 64 patients with bone metastases, 49 (39 women, 10 men, 61±12 years (16-81)), in whom the PET/CT supported the diagnosis of bone metastases, were selected for analysis. A record was made of the SUVmax of a maximum of ten metastases in each patient (total 172: 141 blastic, 31 lytic), as well as four degenerative lesions (total 188) with the greatest18F-NaF uptake intensity. Of the 49 patients analyzed, 43 also had a18F-FDG PET/CT performed in which a record was made of the SUVmax values for18F-FDG calculated in the locations corresponding to the bone metastases observed in the18F-NaF PET/CT: 128 metastases (106 blastic, 22 lytic).
  
  
  RESULTS
  The mean of the SUVmax values was significantly higher in metastases than in degenerative lesions, 26.8±17.3 vs. 15.3±6.3 (P<0.001) and in blastic than in lytic metastases, 27.9±18.3 vs. 22.1±11.3 (P=0.03). A SUVmax value above 42 always represented metastases, with all values above 49 representing blastic metastases. Using the SUVmax values, it was possible to predict the occurrence of metastases (AUC=0.723; P<0.001; 95% CI=0.671-0.776). The mean of the SUVmax with18F-NaF was significantly higher in blastic metastases (27.9±18.3 vs. 22.1±11.3, P=0.03), whereas with18F-FDG it was significantly higher in lytic ones (3.9±3.4 vs. 9.6±3.3; P<0.01).
  
  
  CONCLUSIONS
  SUVmax can contribute to the differentiation of metastases from degenerative lesions, and blastic from lytic metastases.
authors: Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, Portugal. Electronic address: paula.alexandra.lapa@gmail.com.
authors: P
authors: P
authors: Lapa
authors: Technology and Information Systems Department, Centro Hospitalar e Universitário de Coimbra, Portugal; Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Portugal.
authors: M
authors: M
authors: Marques
authors: Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, Portugal.
authors: G
authors: G
authors: Costa
authors: Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health-ICNAS, University of Coimbra, Portugal.
authors: J P
authors: JP
authors: Lima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D010014:Osteolysis / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies; D012969:Sodium Fluoride / Q000493:pharmacokinetics*; D014018:Tissue Distribution; D055815:Young Adult
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride; C000615276:Fluorine-18
keywords: (18)F-FDG; (18)F-fluoruro de sodio; (18)F-sodium fluoride; Análisis cuantitativo; Bone metastases; Degenerative lesions; Lesiones degenerativas; Metástasis óseas; Positron emission tomography; Quantitative analysis; Tomografía por emisión de positrones