Role of Sodium Fluoride PET Imaging for Identification of Bony Metastases in Prostate Cancer Patients

Hughes, C.; Nix, Jeffrey

doi:10.1007/s11934-015-0500-3

Cited by 6 publications

(22 citation statements)

References 13 publications

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“…Initially approved by the FDA in 1972, this tracer is an inorganic chemical compound that dissociates into Na+ and F-ions. The F-ions are quickly taken up in the active bone by chemisorption and label areas of increased bone growth [56,57]. 18 F-NaF is advantageous due to its rapid bone-specific uptake, lack of blood pool and good axial skeletal visualization due to its integration into the hydroxyapatite-collagen matrix (Figure 2) [10,37].…”

Section: F-nafmentioning

confidence: 99%

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

et al. 2016

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Early detection of recurrent prostate cancer (PCa) is of paramount importance to deliver prompt and accurate therapy reducing the chance of progression to metastatic disease. However, current imaging modalities such as conventional computed tomography, MRI and PET scanning do not provide sufficient sensitivity, especially at lower prostate-specific antigen values. Moreover, biological characterization of PCa has become increasingly important to provide patient-specific therapy and current imaging poorly characterizes disease aggressiveness. The current uprise of novel PET tracers in recurrent and metastatic PCa shows promising, yet variable sensitivities and specificities in detection, indicating the need for further studies. In this review, we highlight current and new PET tracers that have been developed to improve the detection of recurrent and metastatic PCa. KEYWORDS• biochemical recurrenceProstate cancer (PCa) is the most common noncutaneous malignancy in American men with 180,890 new cases and 26,120 deaths estimated in 2016 alone [1]. Recent advances in detection, monitoring and treatment of the disease include the growing use of multiparametric MRI, transrectal ultrasound/fusion MRI-guided biopsies and new focal therapies. Primary definitive therapy options for PCa remain radiation therapy (RT) and radical prostatectomy (RP), which are used with curative intent, although both methods have improved over time. Despite the high success rates in primary treatment, 15-25% of patients still experience biochemical recurrence (BCR), following primary definitive therapy with RP or RT [2][3][4][5][6][7]. The definition of BCR varies between therapy methods. For instance, following RP a rising PSA above 0.2 ng/ml defines BCR whereas following RT BCR is defined as a PSA change of 2.0 ng/ml above the nadir following RT and is known as the Phoenix criteria [7]. As rising PSA in post primary therapy patients is an indicator of PCa BCR, close monitoring of serum PSA levels following treatment is critical [7,8]. In the case of BCR, early detection and initiation of therapy is a key to better long-term outcomes. Early intervention is associated with a lower rate of metastatic disease. Thus, accurate and early detection of recurrence leading to earlier treatment will aid in hindering the progression of BCR to metastatic disease.Multiple imaging modalities exist for the detection of recurrent PCa including computed tomography (CT), bone scintigraphy, MRI and PET. However, the need for more sensitive and specific imaging modalities to detect early recurrent and metastatic PCa has been prompted by evidence supporting early treatment. In addition to more sensitive and specific imaging, there has been a 'thrust' toward personalized and targeted management to discover disease phenotype and predict clinical outcomes earlier, which PET/CT has answered the call [9]. The future demands more For reprint orders, please contact: reprints@futuremedicine.com

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Section: F-nafmentioning

confidence: 99%

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

et al. 2016

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“…[4] This has stimulated the investigation of other imaging modalities including hybrid positron emission tomography-CT (PET-CT) with a variety of biologically relevant radiotracers in prostate cancer. [5] The most common PET radiotracer is 18 F-fluorodeoxyglucose (FDG) that tracks glucose metabolism in tumors. However, FDG PET-CT is useful in only a small fraction of patients with biochemical recurrence.…”

Section: Introductionmentioning

confidence: 99%

“…[6] The role of other PET radiotracers such as those targeted to the gastrin-releasing peptide receptor, prostate-specific membrane antigen, and androgen receptor need further investigation. Radiotracers targeted to lipogenesis pathway (e.g., 11 C-acetate, 18 F-or 11 C-choline) can be useful in this clinical setting with a diagnostic performance that depends on serum PSA level and kinetics. [7][8][9][10][11][12][13][14] These studies have largely been limited to Europe, with limited availability in the United States despite Food and Drug Administration (FDA) approval for 11 C-choline for the imaging evaluation of biochemical recurrence.…”

Section: Introductionmentioning

confidence: 99%

“…There has been renewed interest in 18 F-sodium fluoride ( 18 F-NaF) as a PET radiotracer for detection of osseous metastases. 18 F-NaF has favorable properties as a radiotracer for bone imaging; it accumulates in bone rapidly and clears quickly from the circulation, allowing for a high bone-to-background uptake ratio within a short time. PET-CT also allows for high spatial resolution and quantitation.…”

Section: Introductionmentioning

confidence: 99%

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Prostate-specific antigen and prostate-specific antigen kinetics in predicting 18F-sodium fluoride positron emission tomography-computed tomography positivity forfirst bone metastases in patients with biochemical recurrence after radical prostatectomy

et al. 2017

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We evaluated the association between serum prostate specific antigen (PSA) level and kinetics to predict 18F-sodium fluoride positron emission tomography-computed tomography (18F-NaF PET-CT) positivity for first bone metastases in men with biochemical recurrence after radical prostatectomy. All 18F-NaF PET-CT scans that were performed at our institution during 2010–2014 were queried to find patients who demonstrated biochemical recurrence after radical prostatectomy. Records were reviewed to obtain data on PSA levels and kinetics at the time of 18F-NaF PET-CT and pathologic features of the prostatectomy specimen, which were then used for receiver operating characteristic (ROC) analysis to determine predictability for 18F-NaF PET positivity. Thirty-six patients met our inclusion criteria. Of these, 8 (22.2%) had positive 18F-NaF PET-CT scans. Mean values for PSA, PSA doubling time (PSADT), and PSA velocity (PSAV) were 2.02 ng/ml (range: 0.06–11.7 ng/ml), 13.2 months (range: 1.11–60.84), and 1.28 ng/ml/year (range: 0.1–5.28) for 18F-NaF PET-CT negative scans, and 4.11 ng/ml (range: 0.04–14.38 ng/ml), 8.9 months (range; 0.7–27.8), and 9.06 ng/ml/year (range: 0.04–50.2) for 18F-NaF PET-CT positive scans, respectively (P = 0.07, 0.47, and 0.02, respectively, for PSA, PSADT, and PSAV). ROC analysis for 18F-NaF PET-CT positivity resulted in area under the curve (AUC) values of 0.634 for PSA, 0.598 for PSADT, and 0.688 for PSAV. ROC analysis with combined models gave AUC values of 0.723 for a combination of PSA and PSADT, 0.689 for a combination of PSA and PSAV, and 0.718 for grouping of PSA, PSADT, and PSAV. There was no significant association between 18F-NaF PET-CT positivity and primary tumor Gleason score, TN staging, and status of surgical margins. 18F-NaF PET-CT detected first-time osseous metastases in 22.2% of our patients with biochemical recurrence after prostatectomy with the PSA level range ≤11.7 ng/ml. PSAV was statistically significant in predicting 18F-NaF PET-CT positivity. ROC analysis demonstrated higher AUCs when PSA was combined with PSA kinetics parameters.

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“…16,17 Apresenta elevada especificidade porque a CT da PET/CT, ao caracterizar morfologicamente as alterações funcionais, contribui para a diferenciação entre lesões benignas e metástases ósseas. 10 Permite, assim, otimizar o estadiamento, selecionar a melhor estraté-gia terapêutica na altura mais adequada 18 e é mais eficaz na avaliação da resposta ao tratamento instituído, 19 tendo superior impacto na abordagem dos doentes oncológicos com metástases ósseas. 20,21 Na nossa experiência, a PET/CT com FNa-F18 também apresentou maior capacidade de deteção que a CO (em 49% dos casos) e fê-lo de um modo mais assertivo, necessitando de exames complementares para melhor esclarecimento num número muito menor de doentes (3,5% vs 45%).…”

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Superioridade da PET/CT com FNa-F18 na Deteção de Metástases Ósseas quando Comparada com Outros Métodos de Diagnóstico por Imagem

et al. 2017

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RESUMOIntrodução: A tomografia por emissão de positrões/tomografia computorizada -FNa-F18 vem sendo considerada como uma modalidade imagiológica com vantagens na pesquisa de metastização óssea. Comparámos a sua capacidade para deteção de metástases ósseas com a de outras técnicas imagiológicas. Material e Métodos: Avaliámos retrospetivamente 114 doentes que realizaram tomografia por emissão de positrões/tomografia computorizada -FNa-F18. Destes, 49 realizaram também cintigrafia óssea, 61 tomografia por emissão de positrões/tomografia computorizada -FDG-F18 e 10 tomografia por emissão de positrões/tomografia computorizada -FCH-F18. Identificámos a técnica que detetou um maior número de metástases ósseas. Comparámos ainda a tomografia por emissão de positrões com a componente tomografia computorizada da tomografia por emissão de positrões/tomografia computorizada -FNa-F18. Registámos as situações nas quais a tomografia por emissão de positrões/tomografia computorizada FNa-F18 e a cintigrafia óssea necessitaram de exames adicionais para esclarecimento complementar. Resultados: A tomografia por emissão de positrões/tomografia computorizada -FNa-F18 foi superior à cintigrafia óssea em 49% dos doentes (p < 0,001); foi superior à tomografia por emissão de positrões/tomografia computorizada -FDG-F18 em 59% dos doentes (p < 0,001) e foi superior à tomografia por emissão de positrões/tomografia computorizada -FCH-F18 em 40% dos doentes (p < 0,001). Nenhuma das técnicas imagiológicas avaliadas lhe foi superior. Na tomografia por emissão de positrões/tomografia computorizadaFNa-F18 a componente tomografia por emissão de positrões foi superior à tomografia computorizada em 35% dos casos (p < 0,001). Foi sugerida investigação complementar em apenas 3,5% dos doentes que realizaram tomografia por emissão de positrões/tomografia computorizada -FNa-F18 (45% para a cintigrafia óssea) (p < 0,001). Discussão: Em conformidade com o referido por outros autores, a nossa experiência confirma que a tomografia por emissão de positrões/tomografia computorizada -FNa-F18 tem excelente desempenho na deteção de metástases ósseas, sendo capaz de identificar lesões em mais doentes, e em maior número, quando comparada com outras técnicas imagiológicas. Conclusão: A tomografia por emissão de positrões/tomografia computorizada -FNa-F18 revelou superioridade na deteção de metástases ósseas comparativamente à cintigrafia óssea, à tomografia por emissão de positrões/tomografia computorizada -FDG-F18 e à tomografia por emissão de positrões/tomografia computorizada -FCH-F18. Palavras-chave: Cintigrafia; Neoplasias Ósseas/diagnóstico por imagem; Neoplasias Ósseas/secundário; Tomografia por Emissão de Positrões ABSTRACT Introduction: The 18F-NaF positron emission tomography/computed tomography is being considered as an excellent imaging modality for bone metastases detection. This ability was compared with other imaging techniques. Material and Methods:We retrospectively evaluated 114 patients who underwent 18F-NaF positron emission tomography/computed to...

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Role of Sodium Fluoride PET Imaging for Identification of Bony Metastases in Prostate Cancer Patients

Cited by 6 publications

References 13 publications

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

Prostate-specific antigen and prostate-specific antigen kinetics in predicting 18F-sodium fluoride positron emission tomography-computed tomography positivity forfirst bone metastases in patients with biochemical recurrence after radical prostatectomy

Superioridade da PET/CT com FNa-F18 na Deteção de Metástases Ósseas quando Comparada com Outros Métodos de Diagnóstico por Imagem

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