Comparison of ¹⁸F-fluoride PET/CT, ¹⁸F-FDG PET/CT and bone scintigraphy (planar and SPECT) in detection of bone metastases of differentiated thyroid cancer: a pilot study

Br J Radiol. 2014 Feb;87(1034):20130444. doi: 10.1259/bjr.20130444.

Abstract

Objective: We compared the efficacies of ¹⁸F-fluoride positron emission tomography (¹⁸F-fluoride PET)/CT, ¹⁸F-fludeoxyglucose PET (¹⁸F-FDG PET)/CT, and ⁹⁹mTc bone scintigraphy [planar and single photon emission CT (SPECT)] for the detection of bone metastases in patients with differentiated thyroid carcinoma (DTC).

Methods: We examined 11 patients (8 females and 3 males; mean age 6 standard deviation, 61.968.7 years) with DTC who had been suspected of having bone metastases after total thyroidectomy and were hospitalized to be given ¹³¹I therapy. Bone metastases were verified either when positive findings were obtained on both ¹³¹I scintigraphy and CT or when MRI findings were positive if MRI was performed.

Results: Metastases were confirmed in 24 (13.6%) of 176 bone segments in 9 (81.8%) of the 11 patients. The sensitivities of ¹⁸F-fluoride PET/CT and ⁹⁹mTc bone scintigraphy (SPECT) were significantly higher than those of ¹⁸F-FDG PET/CT and ⁹⁹mTc bone scintigraphy (planar) (p,0.05). The accuracies of ¹⁸F-fluoride PET/CT and mTc bone scintigraphy (SPECT) were significantly higher than that of ⁹⁹mTc bone scintigraphy (planar) (p,0.05).

Conclusion: The sensitivity and accuracy of ¹⁸F-fluoride PET/CT for the detection of bone metastases of DTC are significantly higher than those of ⁹⁹mTc bone scintigraphy (planar). However, the sensitivity and accuracy of ⁹⁹mTc bone scintigraphy (planar) are improved near to those of ¹⁸F-fluoride PET/CT when SPECT is added to a planar scan. The sensitivity of ¹⁸F-FDG PET/CT is significantly lower than that of 18F-fluoride PET/CT or ⁹⁹mTc bone scintigraphy (SPECT).

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma, Follicular / diagnosis*
  • Adenocarcinoma, Follicular / secondary*
  • Adenocarcinoma, Follicular / surgery
  • Aged
  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / secondary*
  • Bone and Bones / diagnostic imaging
  • Carcinoma, Papillary / diagnosis*
  • Carcinoma, Papillary / secondary*
  • Carcinoma, Papillary / surgery
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Pilot Projects
  • Positron-Emission Tomography / methods
  • Sensitivity and Specificity
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed / methods

Substances

  • Fluorodeoxyglucose F18