18F-NaF-PET/CT and99mTc-MDP Bone Scintigraphy in the Detection of Bone Metastases in Prostate Cancer.
99mTc-MDP whole-body bone scintigraphy is a highly sensitive imaging method that has been used for decades to evaluate prostate cancer bone metastasis based on its availability and low cost; however, because of accumulation of this radiotracer in degenerative, traumatic, and inflammatory lesions, it suffers from noncomparable specificity. The modality is also used to monitor response to therapy and to predict patients' prognosis. As planar imaging may not give enough information for lesion detection or anatomical localization, it can be supplemented with SPECT to increase image contrast particularly in the evaluation of small and complex skeleton. In addition, hybrid SPECT/CT can be used to assess both functional and morphologic changes leading to more accurate detection of the metastatic bone lesions in a single-section test.18F-NaF-PET/CT offers excellent advantages in investigating bone metastases. It provides greater spatial resolution and better image quality, resulting in better sensitivity and specificity. Furthermore,18F-NaF-PET/CT is able to evaluate response to therapy more accurately and to detect occult bone metastases in lower prostate-specific antigen levels when comparing with conventional99mTc-labeled whole-body bone scan. Owing to smaller administered dose and shorter half-life of18F-NaF, the total actual radiation absorbed dose is almost comparable with99mTc-labeled conventional bone scintigraphy. Hence, we believe that conventional bone scintigraphy would be replaced by18F-NaF-PET/CT in the assessment of metastatic bone disease where PET/CT scanners are available.
Department of Nuclear Medicine and Endocrinology, PET-CT Center LINZ, St Vincent's Hospital, Linz, Austria.
Werner
W
Langsteger
Department of Nuclear Medicine and Endocrinology, PET-CT Center LINZ, St Vincent's Hospital, Linz, Austria.
Alireza
A
Rezaee
Department of Nuclear Medicine, Private Medical University, Salzburg, Austria.
Christian
C
Pirich
Department of Nuclear Medicine and Endocrinology, PET-CT Center LINZ, St Vincent's Hospital, Linz, Austria. Electronic address: mohsen.beheshti@bhs.at.
Mohsen
M
Beheshti
D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012969:Sodium Fluoride; D013669:Technetium Tc 99m Medronate
D005462:Fluorine Radioisotopes; D012969:Sodium Fluoride; D013669:Technetium Tc 99m Medronate