¹⁸F-fluoride PET/CT for assessing bone involvement in prostate and breast cancers

Nucl Med Commun. 2011 Mar;32(3):168-76. doi: 10.1097/MNM.0b013e3283412ef5.


Objective: To evaluate the accuracy of ¹⁸F-fluoride PET/computed tomography (CT) to detect bone metastases (BMs) in a breast and prostate cancer population, using magnetic resonance imaging (MRI) or thin-slice CT as a gold standard.

Methods: We have prospectively included 34 patients with breast (N=24) or prostate cancer (N=10) at high risk of BMs. Whole-body PET/CT (low-dose CT) and bone scintigraphy (BS) with single photon emission CT were obtained for all 34 patients and the results compared with a radiological gold standard.

Results: Out of the 386 foci detected by PET/CT, 219 (56.7%) could be verified by CT or MRI. Eighty-six additional foci were detected by BS (n=46) or seen only by CT (n=9), MRI (n=23), or both CT and MRI (n=8). The total number of verified lesions was therefore 274 (58.1%), including 119 (43.4%) benign and 155 (56.6%) BM. The sensitivity, specificity, and accuracy of ¹⁸F-fluoride PET/CT were 76, 84.2, and 80%, respectively. For BS, they were 44.8, 79.2, and 60%, respectively. Sensitivity significantly decreased for the lytic lesions. The accuracy of PET/CT was significantly superior to BS for pelvic and lumbar lesions. PET/CT provided a correct diagnosis (M+/M0) in 32 of 33 patients (one false positive) compared with 28 of 33 with BS (four false positive, one false positive).

Conclusion: ¹⁸F-fluoride PET/CT is significantly more accurate than BS for detecting BMs from breast and prostate cancers.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / pathology*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Positron-Emission Tomography*
  • Prostatic Neoplasms / pathology*
  • Reference Standards
  • Sensitivity and Specificity
  • Technetium Tc 99m Medronate
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed*


  • Fluorodeoxyglucose F18
  • Technetium Tc 99m Medronate