Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[18F] F and [18F]FDG: a Focus on Skeletal Lesions

Ida Sonni; Ryogo Minamimoto; Lucia Baratto; Sanjiv S Gambhir; Andreas M Loening; Shreyas S Vasanawala; Andrei Iagaru

doi:10.1007/s11307-019-01392-9

Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[¹⁸F] F and [¹⁸F]FDG: a Focus on Skeletal Lesions

Mol Imaging Biol. 2020 Apr;22(2):397-406. doi: 10.1007/s11307-019-01392-9.

Authors

Ida Sonni¹, Ryogo Minamimoto¹, Lucia Baratto¹, Sanjiv S Gambhir², Andreas M Loening^{2

3}, Shreyas S Vasanawala^{3

4}, Andrei Iagaru⁵

Affiliations

¹ Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA, 94305, USA.
² Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, CA, USA.
³ Division of Body MRI, Department of Radiology, Stanford University, Stanford, CA, USA.
⁴ Radiological Science Laboratory, Department of Radiology, Stanford University, Stanford, CA, USA.
⁵ Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA, 94305, USA. aiagaru@stanford.edu.

PMID: 31236756
DOI: 10.1007/s11307-019-01392-9

Abstract

Purpose: The purpose of this study is to prospectively evaluate the performance of sodium ¹⁸F]fluoride (Na[¹⁸F]F)/2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) simultaneous time-of-flight enabled positron emission tomography (PET)/magnetic resonance imaging (MRI) for the detection of skeletal metastases in selected patients with advanced breast and prostate cancers.

Procedure: The institutional review board approved this HIPAA-compliant protocol. Written informed consent was obtained from each patient. A total of 74 patients (23 women and 51 men with breast and prostate cancer, respectively) referred for standard-of-care whole-body bone scintigraphy (WBBS) were enrolled in this prospective study. All patients underwent a [^99mTc]methyldiphosphonate ([^99mTc]MDP) WBBS followed by Na[¹⁸F]F/[¹⁸F]FDG PET/MRI. Lesions detected by each imaging modality were tabulated and a lesion-based and patient-based analysis was conducted.

Results: On a patient-based analysis, [^99mTc]MDP WBBS identified skeletal lesions in 37 patients and PET/MRI in 45 patients. On a lesion-based analysis, WBBS identified a total of 81 skeletal lesions, whereas PET/MRI identified 140 lesions. Additionally, PET/MRI showed extra-skeletal lesions in 19 patients, including lymph nodes (16), prostate (4) lung (3), and liver (2) lesions.

Conclusions: The ability of Na[¹⁸F]F/[¹⁸F]FDG PET/MRI to identify more skeletal lesions than ^99mTc-MDP WBBS and to additionally identify extra-skeletal disease may be beneficial for patient care and represent an alternative to the single modalities performed separately. Na[¹⁸F]F/[¹⁸F]FDG PET/MRI is a promising approach for evaluation of skeletal and extra-skeletal lesions in a selected population of breast and prostate cancer patients.

Keywords: Breast and prostate cancer; Magnetic resonance imaging; Na[18F]F/[18F]FDG PET/MRI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Bone Neoplasms / diagnostic imaging*
Bone Neoplasms / secondary
Breast Neoplasms / diagnostic imaging*
Breast Neoplasms / pathology
Female
Fluorodeoxyglucose F18*
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging*
Male
Middle Aged
Multimodal Imaging / methods
Positron-Emission Tomography*
Prospective Studies
Prostatic Neoplasms / diagnostic imaging*
Prostatic Neoplasms / pathology
Radionuclide Imaging
Radiopharmaceuticals
Sodium
Sodium Fluoride*
Technetium Tc 99m Medronate
Whole Body Imaging

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18
Sodium Fluoride
Sodium
Technetium Tc 99m Medronate